Simple ultrasound exam may predict osteoporosis risk

OAK BROOK, Ill. – An ultrasound exam of the heel may be able to predict if a woman is at heightened risk for fractures due to osteoporosis, according to a new multicenter study being published in the July issue of the journal Radiology. Along with certain risk factors, including age or recent fall, radiation-free ultrasound of the heel may be used to better select women who need further bone density testing, such as a dual-energy x-ray absorptiometry (DXA) exam.

"Osteoporosis is a major public health issue expected to increase in association with worldwide aging of the population," said the study's lead author Idris Guessous, M.D., senior research fellow in the
Department of Internal Medicine at Lausanne University Hospital in Switzerland. "The incidence of osteoporosis will outpace economic resources, and the development of strategies to better identify women who need to be tested is crucial."

Osteoporosis is a disease that is characterized by low bone mass and the deterioration of bone tissue and is a major public health threat. According to the National Osteoporosis Foundation, 10 million Americans currently have osteoporosis and approximately 34 million more are estimated to have low bone mass, increasing their risk of developing the disease. Eighty percent of those affected are women.

"Patients with osteoporosis are not optimally treated because of a lack of general awareness," Dr. Guessous said. "A simple prediction rule might be a useful clinical tool for healthcare providers to optimize osteoporosis screening."

In the three-year multicenter study, 6,174 women age 70 to 85 with no previous formal diagnosis of osteoporosis were screened with heel-bone quantitative ultrasound (QUS), a diagnostic test used to assess bone density. QUS was used to calculate the stiffness index, which is an indicator of bone strength, at the heel. Researchers added in risk factors such as age, history of fractures or a recent fall to the results of the heel-bone ultrasound to develop a predictive rule to estimate the risk of fractures. The results showed that 1,464 women (23.7 percent) were considered lower risk and 4,710 (76.3 percent) were considered higher risk.

Study participants where mailed questionnaires every six months for up to 32 months to record any changes in medical conditions, including illness, changes in medications or any fracture. If a fracture had occurred, the patients were asked to specify the fracture's precise location and trauma level and to include a medical report from the physician in charge.

In the group of higher risk women, 290 (6.1 percent) developed fractures whereas only 27 (1.8 percent) of the women in the lower risk group developed fractures. Among the 66 women who developed a hip fracture, 60 (90 percent) were in the higher risk group.

The results show that heel QUS is not only effective at identifying high-risk patients who should receive further testing, but also may be helpful in identifying patients for whom further testing can be avoided.

"Heel QUS in conjunction with clinical risk factors can be used to identify a population at a very low fracture probability in which no further diagnostic evaluation may be necessary," Dr. Guessous said.

Source: Radiological Society of North America

Related stories:

That tastes -- sweet? Sour? No, it's definitely calcium!
Chemists in Philadelphia are reporting a discovery that could expand the palate of human tastes — sweet, sour, salty, bitter, and savory — to include a new taste sensation that they term "calcium."
Hip Bone Density Helps Predict Breast Cancer Risk
Measuring a woman’s bone mineral density can provide additional information that may help more accurately determine a woman’s risk of developing breast cancer. That is the conclusion of a new study published in the September 1, 2008 issue of Cancer, a peer-reviewed journal of the American Cancer Society. The study’s results suggest that incorporating bone mineral density tests with current risk assessments might significantly improve physicians’ ability to predict breast cancer risk in older, postmenopausal women.
New blood clot guidelines for pregnant women
Blood clot recommendations highlight challenges for pediatric and pre-surgery populations
New evidence-based guidelines address the prevention and management of thrombosis in key patient populations and reinforce recommendations related to the routine use of preventive therapies. Published as a supplement in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), Antithrombotic and Thrombolytic Therapy: ACCP Evidence-Based Clinical Practice Guidelines, Eighth Edition was developed by an international panel of 90 experts and includes more than 700 of the most comprehensive recommendations related to the prevention, treatment, and long-term management of thrombotic disorders. The guidelines include chapters on the challenges in preventing and treating thrombosis in pregnant women and children, and on managing peri- and postoperative patients, while also reinforcing previous guidelines related to the routine use of preventive therapies, including aspirin.
Anti-estrogen drug therapy reduces risk of invasive breast cancer in older women
New analysis of a drug approved for osteoporosis prevention and treatment has provided definitive evidence that the medication is also effective as a breast cancer preventative for certain cancers. Women who took the drug raloxifene were less likely to develop invasive, estrogen-receptor (ER) positive breast cancer compared with women who did not take the drug. The results of the randomized controlled trial will be published in the June 10 online issue of the Journal of the National Cancer Institute.
Prevent a bone break, drink milk to boost calcium
Boosting calcium intake by drinking milk could reduce healthy adults' chances of a debilitating bone break. In a new study published in the American Journal of Clinical Nutrition, healthy men and women supplemented with 1,200 mg of calcium per day - the amount in four glasses of milk - reduced their risk of bone fractures by 72 percent.
Study shows how to lose weight without losing bone
A higher-protein diet that emphasizes lean meats and low-fat dairy foods as sources of protein and calcium can mean weight loss without bone loss--and the evidence is in bone scans taken throughout a new University of Illinois study.
Oocyte-specific gene mutations cause premature ovarian failure
Mutations in a gene called FIGLA cause premature ovarian failure in at least a percentage of women who suffer from the disorder, said researchers from Baylor College of Medicine in Houston and Shandong University in China in a report that appears online today in the American Journal of Human Genetics.
Bone drug could help prevent the spread of breast cancer
Maintaining bone density could be a key to decreasing the spread of cancer in women with locally advanced breast cancer, according to research at Washington University School of Medicine in St. Louis.

News discussion:

Medicine & Health news