Advancing Methods of Assessing Bone Quality to Expand Screening for Osteoporosis

Area of Science:

• Osteoporosis screening
• Bone mineral density assessment
• Diagnostic imaging technologies

Background:

• Dual-energy x-ray absorptiometry (DXA) is limited by machine size, operational requirements, and radiation exposure.
• There is a need for accessible and efficient osteoporosis screening methods.

Purpose of the Study:

• To establish calcaneus ultrasonography (US) data ranges corresponding to DXA-defined bone mineral density (BMD) stratification.
• To determine if vitamin D concentration enhances US bone health assessment.

Main Methods:

• Recruited patients scheduled for DXA at a rural primary care facility.
• Performed calcaneus ultrasonography (US) and collected blood for vitamin D analysis.
• Analyzed correlations between DXA, US, and vitamin D levels using receiver operator characteristic curves.

Main Results:

• Calcaneus US readings predicted bone quality, with no significant difference between left and right feet.
• US BMD T scores showed area under the curve values of 0.69 (left) and 0.68 (right).
• No correlation was found between US/DXA-assessed BMD and vitamin D levels.

Conclusions:

• Calcaneus ultrasonography provides a low-cost, efficient method for screening bone health.
• The study established a US T score threshold of -1.05 to differentiate good from poor bone quality.
• US is a mobile and affordable screening tool applicable to large populations.