Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

Abstract

ObJEcTIVE. bone health is a major concern in patients with Turner syndrome (TS).

The assessment of skeletal status in young patients with Turner syndrome by 2 densitometric techniques: Phalangeal quantitative ultrasound and dual energy X-ray absorptiometry

“…9 Moreover, they found no differences in the total vBMD Z-score or the trabecular vBMD Z-score at the distal radius. Using ultrasound methods, comparable results were obtained by Zuckerman-Levin et al and Vierucci et al 24,26 As in our study, they found reduced phalangeal Ad-SoS, and radial and tibial SoS in girls and women with TS. As with pQCT data, abnormal QUS results may imply structural abnormalities in cortical bone in TS.…”

“…28,29 This percentage is not higher than in a healthy population, because fractures are also common in youth, with 1/3 of all children sustaining at least 1 fracture before the age of 17 years. 30,31 Our finding varies from a paper by Vierucci et al 26 They found a slightly increased risk of fracture in TS girls. In the study, 62.5% of their TS patients had an Ad-SoS Z-score of <−2 and only 1 TS patient with positive history of fracture had normal QUS values, whereas 67% of our TS girls with a previous history of fracture had an Ad-SoS Z-score of >−2.…”

Body composition and bone mineral status in patients with Turner syndrome

“…AD-SOS and BUA are thought to be more sensitive in detecting the bone mineral status and fracture risk in girls with TS than BMD alone22. AD-SOS is a measure of the speed at which the ultrasound of a particular amplitude passes through the bone and soft tissue and reflects the bone architecture and elasticity23.…”

Bone Fragility in Turner Syndrome: Mechanisms and Prevention Strategies

“…Strategies to prevent osteoporosis and fractures should been considered in TS subjects, just during pediatric age ( 87 ). In the first instance, bone mineral status should been assessed in childhood to detect TS subjects at increased risk of bone impairment and in order to carry out preventive measures ( 25 ). In particular, it is preferable to use diagnostic methods that take into account for reduced bone size of these patients, such as pQCT or volumetric transformation of DXA data ( 88 ).…”

“…Moreover, the use of non-invasive and radiation-free tools, such as phalangeal quantitative ultrasound (QUS), can be particularly useful for routinely assessing of BMD in children and adolescents with TS ( 25 ).…”