Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Abstract

Effective prevention and management of osteoporosis would require suitable methods for population screenings and early diagnosis. Current clinically-available diagnostic methods are mainly based on the use of either X-rays or ultrasound (US). All X-ray based methods provide a measure of bone mineral density (BMD), but it has been demonstrated that other structural aspects of the bone are important in determining fracture risk, such as mechanical features and elastic properties, which cannot be assessed using densitometric techniques. Among the most commonly used techniques, dual X-ray absorptiometry (DXA) is considered the current "gold standard" for osteoporosis diagnosis and fracture risk prediction. Unfortunately, as other X-ray based techniques, DXA has specific limitations (e.g., use of ionizing radiation, large size of the equipment, high costs, limited availability) that hinder its application for population screenings and primary care diagnosis. This has resulted in an increasing interest in developing reliable pre-screening tools for osteoporosis such as quantitative ultrasound (QUS) scanners, which do not involve ionizing radiation exposure and represent a cheaper solution exploiting portable and widely available devices. Furthermore, the usefulness of QUS techniques in fracture risk prediction has been proven and, with the last developments, they are also becoming a more and more reliable approach for assessing bone quality. However, the US assessment of osteoporosis is currently used only as a pre-screening tool, requiring a subsequent diagnosis confirmation by means of a DXA evaluation. Here we illustrate the state of art in the early diagnosis of this "silent disease" and show up recent advances for its prevention and improved management through early diagnosis.

Nanotechnology for treating osteoporotic vertebral fractures

“…Micron-sized BaSO 4 and zirconium dioxide (ZrO 2 ) particles have been used as radiopacifiers in bone cements for years. 79 However, the evidence shows that adding high contents of micron-sized BaSO 4 or ZrO 2 is detrimental to the mechanical and biological properties of bone cement.…”

“…Micron-sized BaSO 4 and zirconium dioxide (ZrO 2 ) particles have been used as radiopacifiers in bone cements for years. 79 However, the evidence shows that adding high contents of micron-sized BaSO 4 or ZrO 2 is detrimental to the mechanical and biological properties of bone cement. For example, addition of micron-sized BaSO 4 particles decreased the tensile strength of PMMA bone cement from 45 MPa to 36 MPa, since agglomerates of BaSO 4 could serve as initiation sites for fatigue cracks.…”

“…2 For measuring bone density and evaluating osteoporosis or fracture risk prediction, dual X-ray absorptiometry is considered the "gold standard" method, 3 while ultrasound methodology has been developed for population screening and diagnosis in primary care. 4,5 In clinical practice, according to osteoporotic condition, osteoporosis is usually categorized as primary or secondary osteoporosis. With the increased life expectancy and rapidly aging population worldwide, osteoporosis has become a major public health problem in many countries.…”

“…Radiopacifiers such as BaSO 4 and ZrO 2 are barely soluble, and release of such particles may result in a biocompatibility hazard. Due to their large surface area-to-volume ratio, a lower concentration of radiopaque nanoparticles can have the same radiopacity as a large amount of micron-sized radiopacifier.…”

Mechanism of enhanced antiosteoporosis effect of circinal–icaritin by self-assembled nanomicelles in vivo with suet oil and sodium deoxycholate

“…7 Therefore, in order to improve the bioavailability and the antiosteoporosis effects of CIT, SO was used to prepare CIT, and DOC was used to represent one of the main bile salts. Subsequently, the antiosteoporotic activity between CIT and CIT-SO on the bone metabolism of ovariectomized (OVX) osteoporotic rats was compared by bone mineral density (BMD), 21 bone microarchitecture, bone biomechanical properties, and related protein and gene expressions. Simultaneously, serum biochemical parameters, including serum hydroxyproline (HOP), alkaline phosphatase (ALP), osteoprotegerin (OPG), osteocalcin (OCN), receptor activator of nuclear factor-κB ligand (RANKL), and tartrateresistant acid phosphatase 5b (TRACP-5b) were detected.…”