Quantitative ultrasonometry of the calcaneus in women: Establishing a reference database

Objective: Quantitative ultrasonometry is a radiation-free, low-cost, simpl e, quick and mobile method to evaluate properties of bone. The objective of this study was to evaluate the effectiveness, reliability and age-related findings of this technique in women and to establish a reference database. Methods: In a cross-sectional study we measured speed of sound, broadband u ltrasound attenuation and the stiffness index of the calcaneus in 2272 wome n (mean age, 53.0 +/- 10.5 years) with an ultrasound bone densitometer. Wom en with a history of osteoporosis, osteoporosis-related fractures or those using medications known to affect bone metabolism were excluded. In 791 wom en both calcanei were studied. Results: The short-term precision in vivo, expressed as coefficient of vari ance, was 1.2% for broadband attenuation, 0.2% for speed of sound, and 1.3% for stiffness. In women in whom both calcanei were studied the coefficient of correlation was 0.92 for speed of sound (p <0.001), 0.84 for broadband attenuation (p <0.001), and 0.93 for the stiffness index (p <0.001). The cr oss-sectional analysis showed significant yearly decreases after menopause in speed of sound (0.1%), attenuation (0.5%), and stiffness (0.9%). Between adolescence and old age, attenuation decreased by 22%, speed of sound by 5 %, and stiffness by 38%. Attenuation decreased by 5% before and 17% after m enopause. In contrast, speed of sound decreased continuously from the age o f 15, with a decline of 2% from adolescence to menopause and of 3% after me nopause. The stiffness index decreased by 10% before menopause and by 31% t hereafter. Conclusions: The properties of bone measured with quantitative ultrasonomet ry decline continuously with age. The low precision error and the high corr elation between left and right confirm the high technical standard of the m ethod.