Quantitative ultrasound: a technique to target women with low bone mass for preventive therapy

Assessment of bone mass is the best predictor of fracture. The current challenge is to develop a strategy to determine which women should be targeted for preventive therapy. The cost of dual-energy x-ray absorptiometry equipment precludes its widespread availability in physicians' offices and clinics. Quantitative ultrasound appears to offer a low-cost alternative method to assess bone mass and fracture risk. In addition, ultrasound is radiation free. Quantitative ultrasound values decrease with age, are lower in osteoporotic women, and are influenced by estrogen treatment. The associations observed between quantitative ultrasound and fracture indicate that it is comparable to densitometry in predicting fracture risk. This association remains significant after correction for bone mineral density, suggesting that ultrasound measures additional properties of bone that are determinants of strength. Quantitative ultrasound may prove to be a technique that will allow bone mass testing to become more readily available to the population. The ability of quantitative ultrasound to discriminate those women at greatest risk for fracture will allow physicians to target those women for preventive therapy.