Sl. Greenspan et al., PRECISION AND DISCRIMINATORY ABILITY OF CALCANEAL BONE ASSESSMENT TECHNOLOGIES, Journal of bone and mineral research, 12(8), 1997, pp. 1303-1313
To determine if measuring skeletal status at the calcaneus is a potent
ially valuable technique for diagnosing osteoporosis, we examined five
calcaneal assessment techniques in 53 young normal women and 108 post
menopausal women with osteoporosis and compared these measurements to
dual-energy X-ray absorptiometry (DEXA)) at the calcaneus, hip, and sp
ine. The five instruments, including single-energy X-ray absorptiometr
y (SEXA) and four quantitative ultrasound (QUS) instruments, were eval
uated for precision, ability to discriminate osteoporotic from young n
ormal subjects, and correlation to the other instruments, The coeffici
ent of variation (%CV) for instrument, positioning, interobserver, and
short-term precision of the five calcaneal instruments ranged from 1.
34-7.76%, 1.63-7.00%, 1.84-9.44%, and 1.99-7.04%, respectively, The %C
Vs for positioning, interobserver, and short-term precision were simil
ar for calcaneal DEXA, calcaneal SEXA, and stiffness (as measured by A
chilles), The %CVs for instrument precision were similar between calca
neal DEXA and SEXA. The ability of the five calcaneal instruments to d
iscriminate osteoporotic from young normal subjects was similar based
on the analysis of area under the receiver operating characteristic cu
rves (range 0.88-0.93) and equivalent to DEXA of the calcaneus and hip
(0.88-0.93), The correlations between the measurements of five calcan
eal instruments were strong (0.80 less than or equal to r less than or
equal to 0.91,p < 0.001), These data suggest that although the precis
ion is variable? the calcaneal QUS and SEXA instruments can discrimina
te between osteoporotic patients and young normal controls and appear
to be a useful technique for assessment of osteoporosis.