Ultrasound And Osteoporosis

There is an insidious nature to osteoporosis. It is a gradual loss of bone tissue that is so slow that it is usually not noticed until there is a traumatic event like a fracture. Screens exist that can predict osteoporosis and allow treatment to begin early, and one of the best screens is ultrasound based.

Quantitative ultrasound (QUS) measures the speed of sound and broad band ultrasonic attenuation of the ultrasound beam as it passes between two ultrasound transducers. QUS can become a screen that may be predict future fractures in peri-menopausal and immediate post-menopausal women, and senior citizens of both genders. Those who have low QUS values for the ankle bone, the most common bone screened, are referred for further testing, like measurements of the spine.

QUS works by measuring how the ultrasound machine beam changes as it passes through the bone. The name for this type of ultrasound is Broad Band Ultrasonic Attenuation, or BUA. QUS can also measure how quickly the ultrasound beam passes through the patient’s bone; the name for this is Speed of Sound, abbreviated as SOS.

These two readings when taken together can tell us about how bones are structured, whether or not they are elastic, and how strong they are—in short, measures of the quality of the bone. That can be compared to the bone density. Taken together, these two assessments can help doctors predict each patient’s risk of suffering a bone fracture.

The bones of the foot are used because just like the lumbar spine, as we age these bones change. Spinal changes cause the majority problems in patients with osteoporosis. In addition, QUS is a simple process, the equipment is portable, and for the patient there is no radiation exposure.

Studies have shown that a combination of QUS and an inquiry about personal and familial risk factors would detect more cases of osteoporosis and had slightly better chance to predict fractures than the risk factors inquiry alone. It has also been discovered that ultrasound test alone have much better predictive value than risk factors alone. It is, however, still good clinical practice to do an overall assessment of risk for osteoporosis rather than QUS alone.

Ultrasound machine scanning, therefore, is a simple, quick, safe, portable, and inexpensive clinical test. It can provide physicians an opportunity to improve on the current method of identifying patients at risk for osteoporosis and the associated fractures.

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