CONTRIBUTION OF CALCANEAL ULTRASONIC ASSESSMENT TO THE EVALUATION OF POSTMENOPAUSAL AND GLUCOCORTICOID-INDUCED OSTEOPOROSIS

We evaluated ultrasound propagation through the calcaneus using the Ac hilles(R) Lunar unit in patients with postmenopausal or glucocorticoid -induced osteoporosis. Speed of sound, broadband ultrasound attenuatio n and a combination of these two parameters called stiffness were dete rmined. Reproducibility was 0.23%, 2.6%, and 2.6% for these three para meters, respectively. Bone mineral density measured at the spine and f emoral neck by absorptiometry was significantly correlated with all th ree ultrasound parameters in the women with postmenopausal osteoporosi s (n = 47) and in the controls (n = 42). In the patients with glucocor ticoid-induced osteoporosis (n = 35), only speed of sound was signific antly correlated with the bone mineral density measurements. Mean valu es in the subjects with postmenopausal osteoporosis and in their age-m atched controls were 1473+/-27.2 m/sec versus 1500.6+/-29.6 m/sec for speed of sound, 95.3+/-9.6 dB/Mhz versus 105.7+/-10.1 dB/Mhz for broad band ultrasound attenuation, and 56.1+/-13.2 versus 70.9+/-14.1 for st iffness, indicating a significant difference (P < 0.01). Z scores were -0.91, -1.1, -0.93, -0.97, and -1.05 for bone mineral density at the spine, bone mineral density at the femoral neck, speed of sound, broad band ultrasound attenuation and stiffness, respectively. Receiver Oper ating Characteristic curves showed that there were no statistically si gnificant differences between the ultrasound parameters at the calcane us and the absorptiometry measurements at the spine and femoral neck. Mean values in glucocorticoid-treated patients and age-matched control s were 1480+/-26.9 m/sec versus 1505.1+/-30.3 m/sec for speed of sound , 99.2/-11.4 dB/Mhz versus 105.9+/--10.2 dB/Mhz for broadband ultrasou nd attenuation, and 60.7+/-14 versus 72.1/14.5 for stiffness, again in dicating a significant difference (P less than or equal to 0.01). Z sc ores were -0.55, -0.65, -0.8, -0.67, and -0.78 for bone mineral densit y at the spine, bone mineral density at the femoral neck, speed of sou nd, broadband ultrasound attenuation and stiffness, respectively. Our data suggest that ultrasound parameters measured at the calcaneus are useful for evaluating postmenopausal and glucocorticoid-induced osteop orosis.