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© 1998 Oxford University Press

review-article

Assessment of femoral bone fragility and fracture risk by ultrasonic measurements at the calcaneus

STEVEN BOONEN and PATRICK NICHOLSON1

Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Brusselsestraat 69, B-3000 Leuven, Belgium, and Arthritis and Metabolic Bone Disease Research Unit, Katholieke Universiteit Leuven Belgium
1Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven Belgium

S. Boonen. Fax: (+32) 16 337941

Background: quantitative ultrasound measurement (broadband ultrasound attenuation and speed of sound) is emerging as an alternative to photon absorptiometry techniques in the assessment of osteoporosis.

Objective: to discuss briefly the fundamentals of ultrasound measurement of bone and critically review recent studies on the role of ultrasound in bone quality assessment and hip fracture prediction.

Conclusions: the relationships between ultrasound and bone mineral density are too weak to allow accurate prediction of bone density at any skeletal site—including the hip—from an ultrasound measurement at the calcaneus. However, in vitro evidence indicates that ultrasound provides structural information in addition to density. In line with these in vitro data, recent prospective studies have shown that ultrasound predicts hip fractures strongly and independently of densitometry in older women.

Keywords: bone fragility, calcaneus, hip fracture risk, osteoporosis, quantitative ultrasound

Received June 11, 1997;
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