Screening for osteoporosis: what is the role of heel ultrasound?

Could focused population screening detect osteoporosis earlier and improve the management of this major health care problem? Quantitative ultrasound of the calcaneus is currently being proposed as a suitable screening technique. Correlations between quantitative ultrasound of the calcaneus and dual energy x-ray absorptiometry of bone mineral density of the spine and proximal femur are not high enough to reliably predict bone mineral density at the lumbar spine or proximal femur from the ultrasound results. Some ongoing longitudinal studies suggest that quantitative ultrasound may none the less detect individuals at increased risk of fracture, but its use for mass screening for osteoporosis would be premature.