The use of calcaneal quantitative ultrasound for determining bone mass of the hip

The calcaneal quantitative ultrasound (QUS) measures heel bone mineral density and predicts hip, vertebral spine, and peripheral fractures at the same odds ratio as dual X-ray absorptiometry (DXA). Its portability, performance ease, and low cost makes it an attractive alternative as a screening device, especially in regions with low incomes and high hip fracture rates. The high hip fracture incidence in our area prompted a pilot study comparing the calcaneal QUS and hip DXA in women We found this technology to be only 58% sensitive and 80% specific when compared to the DXA in detecting hip osteopenia or osteoporosis. Moreover, the calcaneal QUS failed to detect 37% of the women with abnormal DXA values. Further investigation is needed to determine whether supplementing the calcaneal QUS with clinical risk factors and changing the cutoff T-score value would improve the sensitivity and maintain the specificity for determining hip osteopenia and osteoporosis.