Heel ultrasound scan in detecting osteoporosis in low trauma fracture patients

Abstract

Osteoporosis is the most common metabolic disease with significant impact on the morbidity and mortality of affected patients. Osteoporosis has a significant impact on the economy worldwide. The aim of this study was to find out whether heel ultrasound is as good as central bone densitometry scanning in diagnosing osteoporosis in patients who are at high risk of osteoporosis. This was a prospective study of patients comparing heel ultrasound to central bone densitometry scanning (dual X-ray absorptiometry, DEXA) in patients. The recruited patients attended for a DEXA scan of the left hip and lumbar spine. All subjects had an ultrasound of the left heel using the quantitative heel ultrasound machine. The results of DEXA scan were blinded from the results of ultrasound and vice versa. There were 59 patients who took part in the study, 12 men and 47 women. The mean age was 66 years (SD 11.9) and mean weight was 62.5 kg (SD 10.7). The sensitivity and specificity of the ultrasound heel test to predict osteoporosis were 53% (95%CI: 29-77) and 86% (95%CI: 75-96) respectively. Specificity for predicting bone mineral density (BMD)-defined osteoporosis was high (86%), but sensitivity was low (53%). A heel ultrasound result in the osteoporotic range was highly predictive of BMD-defined osteoporosis. A positive ultrasound heel test in high risk patients is more useful in ruling in osteoporosis than a negative test to rule out osteoporosis.

Keywords: Osteoporosis; bone mineral density; central bone density; quantitative ultrasound.