ULTRASOUND IN THE EVALUATION OF OSTEOPOROSIS - A COMPARISON WITH BONE-MINERAL DENSITY AT DISTAL RADIUS

It is proven that, from a technical point of view, ultrasound transmis sion velocity (UTV) measurement can easily be taken at the distal end of the radius. The reproducibility of UTV is good (coefficient of vari ation 0.3% intraoperator and 0.5% interoperator). 248 normal and 65 os teoporotic women were then studied to establish the range of UTV value s and to compare the ability of UTV and bone mineral density (BMD) mea surement, taken at the same skeletal sites, to detect osteoporotic fra gility. Osteoporosis was defined by the presence of atraumatic vertebr al fractures on an X-ray of the spine. Ultrasound velocity averaged 15 70.5 +/- 43.3 m s(-1) in normal and 1519.2 +/- 15.2 m s(-1) in osteopo rotic women; the difference is also statistically significant (p < 0.0 1) for BMD. Both BMD and UTV decline after menopause and are significa ntly correlated with age. A weak correlation (r=0.68) was found betwee n UTV and BMD; this supports the thesis that ultrasound velocity measu res bone mass as well as other fragility components of bone distinct f rom the decrease of mass. Receiver operating characteristic (ROC) curv e analysis showed that UTV discriminates between normal and osteoporot ic patients at least as well as radial BMD, indicating that UTV is a n ew available diagnostic modality which can be used to screen osteoporo tic subjects.