Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study.

Luisetto, Giovanni; Camozzi, Valentina; Terlizzi, Francesca de

doi:10.7863/jum.2000.19.4.251

Cited by 16 publications

(3 citation statements)

References 23 publications

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“…Until now, only one study demonstrating the possibility of distinguishing between two different metabolic bone diseases, such as OP and osteomalacia, has been published [34]. Our findings, even though preliminary and obtained from only a small sample of subjects, seem to confirm the possibility of distinguishing between two different bone histologic patterns independently of BMD.…”

Section: Discussionsupporting

confidence: 70%

Graphic Trace Analysis of Ultrasound at the Phalanges May Differentiate Between Subjects with Primary Hyperparathyroidism and with Osteoporosis: A Pilot Study

et al. 2002

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Bone loss characterizes both primary hyperparathyroidism (PHPT) and osteoporosis (OP) but with a different histologic pattern, and this could partially explain the different fracture incidence in these two populations. Quantitative ultrasound (QUS), influenced by bone structural parameters other than bone mineral density (BMD), could evidence these differences, opening new perspectives in the evaluation of patients with metabolic bone diseases. The aim of the present study was to investigate the usefulness of QUS graphic trace parameters, assessed at the phalanx, in discriminating between PHPT bone disease and osteoporosis. We studied 34 patients with PHPT (mean age 59.7 +/- 12.7 years), 35 patients with OP (mean age 60.6 +/- 7.1 years) and 34 healthy subjects as controls (mean age 59.1+/- 9.4 years). In all subjects QUS measurements were performed at the phalanx with a Bone Profiler (IGEA, Italy), obtaining the amplitude-dependent speed of sound (AD-SoS), fast wave amplitude (FWA), signal dynamic (SDy), bone transmission time (BTT) and ultrasound bone profile index (UBPI). Moreover, serum calcium, phosphorus, parathyroid hormone (PTH), bone isoenzyme of alkaline phosphatase (B-ALP) and ionized calcium were measured in all subjects in the morning under fasting conditions. In PHPT patients BTT was correlated with PTH, ionized calcium and B-ALP levels (r = -0.47, -0.57 and -0.44, respectively; p < 0.01), whereas FWA, SDy and UBPI correlated only with B-ALP (r = -0.43, -0.46 and -0.50, respectively; p <0.01). Moreover, FWA, SDY and UBPI were significantly (p<0.01) lower and BTT significantly (p<0.001) higher in OP than in PHPT patients. UBPI, BTT, FWA and the BTT/FWA ratio, but not SDy, were able to discriminate between the two groups (area under the curve =0.66, 0.69, 0.67 and 0.81, respectively). Our findings show that ultrasound signal parameters are differently influenced by bone changes characterizing primary hyperparathyroidism or osteoporosis. This suggests that the QUS signal could be a useful instrument in discriminating and studying some of the bone alterations typical of metabolic bone diseases.

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Section: Discussionsupporting

confidence: 70%

Graphic Trace Analysis of Ultrasound at the Phalanges May Differentiate Between Subjects with Primary Hyperparathyroidism and with Osteoporosis: A Pilot Study

et al. 2002

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“…In contrast, no significant differences were observed with either BMD or ultrasound velocity alone [32]. There can be no doubt of the clinical importance of these observations, which have recently been confirmed in a small clinical series [33]. …”

Section: In Vivo Studiesmentioning

confidence: 79%

Assessment of Bone Architecture with Ultrasonometry: Experimental and Clinical Experience

et al. 2000

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Over the last decade, ultrasound technology has been introduced as a method of analysing bone tissue in clinical practice, and several studies have compared various ultrasound devices with dual-energy X-ray absorptiometry (DXA). Unlike DXA, the ultrasound technique is not limited to the measurement of bone density – it also has the potential to provide information on the mechanical and architectural characteristics of bone. The first generation of ultrasound devices used the speed of sound and attenuation of the ultrasound signal to obtain information on bone mineral content. Second generation ultrasound devices, which analyse the ultrasound signal received, permit the study of bone structure and elasticity, in addition to its mineral content, in both experimental studies and clinical practice. This is accomplished by signal processing analysis, the study of backscattering and the application of Biot’s theory. This approach to the study of bone tissue represents the future for the development of ultrasound technology for use in clinical practice.

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“…QUS is widely employed in detecting different structural changes in patients with different types of osteopenia and several metabolic bone diseases 14–16 . Histomorphometric studies showed that trabecular thickness is reduced in glucocorticoid‐induced osteopenia, but the trabecular network is substantially preserved, as a result of reduced osteoblastic activity rather than of excessive bone resorption 17,18 .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Ultrasound Technology in Evaluating Bone Status and Osteoporosis in Patients with Cushing's Syndrome

Camozzi

Luisetto

Zangari

et al. 2007

Annals of the New York Academy of Sciences

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Osteoporosis is a major feature of Cushing's syndrome (CS), and fragility fractures may be the first sign of the disease. The aim of this study was to evaluate the ability of quantitative ultrasound technology (QUS) in diagnosing osteoporosis in patients with CS. Sixty-three consecutive patients (mean age 38.6 +/- 13.0 years), 13 (20.6%) men and 50 (79.4%) women, with confirmed CS underwent both dual-energy X-ray densitometry (DXA) and QUS. Two groups of patients were selected: group A, 23 patients, T-score -2 SD or less (bone mineral density [BMD] femoral neck < or = 695 g/cm(2)), and group B, 40 patients, T-score above -2 SD. Age (42 +/- 12 vs. 37 +/- 13 years) and 24-h free urinary cortisol (499 +/- 345 vs. 469 +/- 319 microg/day) did not differ significantly (P = NS) between groups, while the body mass index did (24.3 +/- 4.1 vs. 28.1 +/- 4.6, P = 0.002). Unlike DXA, QUS values did not differ significantly (P = NS) between groups. Moreover, in the overall population, as well as in a single group, there was no correlation (R < 0.5, P = NS) between QUS and DXA parameters. In conclusion, in our study QUS was not able to differentiate osteoporotic patients from those with normal BMD measured by DXA, and thus QUS technology should not be used to discriminate between osteopenic and nonosteopenic patients with CS.

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Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study.

Cited by 16 publications

References 23 publications

Graphic Trace Analysis of Ultrasound at the Phalanges May Differentiate Between Subjects with Primary Hyperparathyroidism and with Osteoporosis: A Pilot Study

Graphic Trace Analysis of Ultrasound at the Phalanges May Differentiate Between Subjects with Primary Hyperparathyroidism and with Osteoporosis: A Pilot Study

Assessment of Bone Architecture with Ultrasonometry: Experimental and Clinical Experience

Quantitative Ultrasound Technology in Evaluating Bone Status and Osteoporosis in Patients with Cushing's Syndrome

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