PORTABLE ULTRASOUND ASSESSMENT OF BONE IN THE ELDERLY - HEMIPARESIS FOLLOWING STROKE AS A MODEL FOR DISUSE OSTEOPOROSIS

To evaluate portable bone ultrasound as a technique for the assessment of osteoporosis in disabled and elderly subjects we have used hemipar esis following stroke as a model for disuse osteoporosis. We used the CUBA clinical system in a cross-sectional study of 38 stroke unit and day hospital patients, at an average of 8 months after stroke. On aver age broadband ultrasound attenuation (BUA) was lower by 5.5 dB MHz(-1) in the hemiparetic (mean 65.9 dB MHz(-1)) compared to the normal limb (mean 71.4 dB MHz(-1)). This was significant at P < 0.05 on paired t- test, but appears to reflect the presence of oedema in the weak leg. A total of 16 (42%) of our subjects had such oedema and these subjects showed a larger BUA difference of 9.2 dB MHz(-1). A total of 22 subjec ts without leg oedema showed a smaller BUA difference (2.8 dB Mhz(-1)) . This result is similar to the difference in bone density described i n previous work using dual-energy X-ray absorptiometry (DXA) after str oke, but did not achieve statistical significance (P = 0.4). Bone ultr asound scanning was simple and acceptable to our subjects, but sensiti vity to the presence of oedema may limit its precision in work with di sabled and elderly subjects. (C) 1997 Elsevier Science Ireland Ltd.