Journal of Clinical Densitometry
Volume 11, Issue 1 , Pages 163-187 , January 2008

Quantitative Ultrasound in the Management of Osteoporosis: The 2007 ISCD Official Positions

  • Marc-Antoine Krieg

      Affiliations

    • Lausanne University Hospital, Lausanne, Switzerland
    • Task Force Chair.
    • Corresponding Author InformationAddress correspondence to: Marc-Antoine Krieg, MD, Center of Bone Diseases, Bone and Joint Department – CHUV, Av. Pierre-Decker 4, 1011 Lausanne, Switzerland.
  • ,
  • Reinhart Barkmann

      Affiliations

    • Universitätsklinikum Schleswig-Holstein, Kiel, Germany
    • Task Force Member.
  • ,
  • Stefano Gonnelli

      Affiliations

    • University of Siena, Siena, Italy
    • Task Force Member.
  • ,
  • Alison Stewart

      Affiliations

    • University of Aberdeen, Aberdeen, Scotland, UK
    • Task Force Member.
  • ,
  • Douglas C. Bauer

      Affiliations

    • University of California at San Francisco, San Francisco, CA, USA
    • Task Force Member.
  • ,
  • Luis Del Rio Barquero

      Affiliations

    • Cetir Centre Medic, Barcelona, Spain
    • Task Force Member.
  • ,
  • Jonathan J. Kaufman

      Affiliations

    • CyberLogic, Inc., New York, NY, USA
    • Task Force Member.
  • ,
  • Roman Lorenc

      Affiliations

    • Specjalistyczny Osrodek Medycyny Wieku, Warsaw, Poland
    • Task Force Member.
  • ,
  • Paul D. Miller

      Affiliations

    • Colorado Center for Bone Research, Lakewood, CO, USA
    • Task Force Member.
  • ,
  • Wojciech P. Olszynski

      Affiliations

    • University of Saskatchewan, Saskatoon, SK, Canada
    • Task Force Member.
  • ,
  • Catalina Poiana

      Affiliations

    • “Carol Davila” University of Medicine & Pharmacy, Bucharest, Romania
    • Task Force Member.
  • ,
  • Anne-Marie Schott

      Affiliations

    • Edouard Herriot Hospital, INSERM U 403, Lyon, France
    • Task Force Member.
  • ,
  • E. Michael Lewiecki

      Affiliations

    • New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
    • Task Force Liaison.
  • ,
  • Didier Hans

      Affiliations

    • Geneva University Hospital, Geneva, Switzerland
    • Task Force Member.
    • Task Force Liaison.

Received 5 December 2007 ,Accepted 5 December 2007.

References 

  1. Anonymous . Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med. 1993;94:646–650
  2. Kanis JA, Delmas P, Burckhardt P, et al. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int. 1997;7:390–406
  3. WHO . Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Geneva: World Health Organization; 1994;
  4. Hans D, Downs RW, Duboeuf F, et al. Skeletal sites for osteoporosis diagnosis: the 2005 ISCD Official Positions. J Clin Densitom. 2006;9:15–21
  5. Kanis JA, Gluer CC. An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int. 2000;11:192–202
  6. Njeh CF, Black DM. Calcaneal quantitative ultrasound: water-coupled. London, UK: Martin Dunitz; 1999;109–124
  7. Cheng S, Hans D, Genant HK. Calcaneal quantitative ultrasound: gel-coupled. London, UK: Martin Dunitz; 1999;125–144
  8. Marin F, Gonzalez-Macias J, Diez-Perez A, et al. Relationship between bone quantitative ultrasound and fractures: a meta-analysis. J Bone Miner Res. 2006;21:1126–1135
  9. Gluer CC. Quantitative Ultrasound—it is time to focus research efforts. Bone. 2007;40:9–13
  10. Siffert RS, Kaufman JJ. Ultrasonic bone assessment: “the time has come”. Bone. 2007;40:5–8
  11. Hans D, Fan B, Fuerst T. Non-heel quantitative ultrasound devices. London, UK: Martin Dunitz; 1999;145–162
  12. Gluer CC, Blake G, Lu Y, et al. Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int. 1995;5:262–270
  13. Njeh CF, Hans D, Li J, et al. Comparison of six calcaneal quantitative ultrasound devices: precision and hip fracture discrimination. Osteoporos Int. 2000;11:1051–1062
  14. Alenfeld FE, Wuster C, Funck C, et al. Ultrasound measurements at the proximal phalanges in healthy women and patients with hip fractures. Osteoporos Int. 1998;8:393–398
  15. Augat P, Fan B, Lane NE, et al. Assessment of bone mineral at appendicular sites in females with fractures of the proximal femur. Bone. 1998;22:395–402
  16. Barkmann R, Kantorovich E, Singal C, et al. A new method for quantitative ultrasound measurements at multiple skeletal sites: first results of precision and fracture discrimination. J Clin Densitom. 2000;3:1–7
  17. Bauer DC, Gluer CC, Genant HK, et al. Quantitative ultrasound and vertebral fracture in postmenopausal women. Fracture Intervention Trial Research Group. J Bone Miner Res. 1995;10:353–358
  18. Cepollaro C, Gonnelli S, Pondrelli C, et al. The combined use of ultrasound and densitometry in the prediction of vertebral fracture. Br J Radiol. 1997;70:691–696
  19. Clowes JA, Eastell R, Peel NF. The discriminative ability of peripheral and axial bone measurements to identify proximal femoral, vertebral, distal forearm and proximal humeral fractures: a case control study. Osteoporos Int. 2005;16:1794–1802
  20. Damilakis J, Papadokostakis G, Perisinakis K, et al. Discrimination of hip fractures by quantitative ultrasound of the phalanges and the calcaneus and dual X-ray absorptiometry. Eur J Radiol. 2004;50:268–272
  21. Damilakis J, Papadokostakis G, Vrahoriti H, et al. Ultrasound velocity through the cortex of phalanges, radius, and tibia in normal and osteoporotic postmenopausal women using a new multisite quantitative ultrasound device. Invest Radiol. 2003;38:207–211
  22. Donaldson MM, McGrother CW, Clayton DG, et al. Calcaneal ultrasound attenuation in an elderly population: measurement position and relationships with body size and past fractures. Osteoporos Int. 1999;10:316–324
  23. Drozdzowska B, Pluskiewicz W. The ability of quantitative ultrasound at the calcaneus to identify postmenopausal women with different types of nontraumatic fractures. Ultrasound Med Biol. 2002;28:1491–1497
  24. Drozdzowska B, Pluskiewicz W, de Terlizzi F. The usefulness of quantitative ultrasound at the hand phalanges in the detection of the different types of nontraumatic fractures. Ultrasound Med Biol. 2003;29:1545–1550
  25. Ekman A, Michaelsson K, Petren-Mallmin M, et al. DXA of the hip and heel ultrasound but not densitometry of the fingers can discriminate female hip fracture patients from controls: a comparison between four different methods. Osteoporos Int. 2001;12:185–191
  26. Ekman A, Michaelsson K, Petren-Mallmin M, et al. Dual X-ray absorptiometry of hip, heel ultrasound, and densitometry of fingers can discriminate male patients with hip fracture from control subjects: a comparison of four different methods. J Clin Densitom. 2002;5:79–85
  27. Frediani B, Acciai C, Falsetti P, et al. Calcaneus ultrasonometry and dual-energy X-ray absorptiometry for the evaluation of vertebral fracture risk. Calcif Tissue Int. 2006;79:223–229
  28. Frost ML, Blake GM, Fogelman I. Contact quantitative ultrasound: an evaluation of precision, fracture discrimination, age-related bone loss and applicability of the WHO criteria. Osteoporos Int. 1999;10:441–449
  29. Frost ML, Blake GM, Fogelman I. Does quantitative ultrasound imaging enhance precision and discrimination?. Osteoporos Int. 2000;11:425–433
  30. Frost ML, Blake GM, Fogelman I. Does the combination of quantitative ultrasound and dual-energy X-ray absorptiometry improve fracture discrimination?. Osteoporos Int. 2001;12:471–477
  31. Frost ML, Blake GM, Fogelman I. A comparison of fracture discrimination using calcaneal quantitative ultrasound and dual X-ray absorptiometry in women with a history of fracture at sites other than the spine and hip. Calcif Tissue Int. 2002;71:207–211
  32. Gerdhem P, Magnusson H, Karlsson MK, et al. Ultrasound of the phalanges is not related to a previous fracture. A comparison between ultrasound of the phalanges, calcaneus, and DXA of the spine and hip in 75-year-old women. J Clin Densitom. 2002;5:159–166
  33. Gluer CC, Cummings SR, Bauer DC, et al. Osteoporosis: association of recent fractures with quantitative US findings. Radiology. 1996;199:725–732
  34. Gluer CC, Eastell R, Reid DM, et al. Association of five quantitative ultrasound devices and bone densitometry with osteoporotic vertebral fractures in a population-based sample: the OPUS Study. J Bone Miner Res. 2004;19:782–793
  35. Gnudi S, Gualtieri G, Malavolta N. Simultaneous densitometry and quantitative bone sonography in the estimation of osteoporotic fracture risk. Br J Radiol. 1998;71:625–629
  36. Gnudi S, Ripamonti C. Quantitative ultrasound at the phalanxes discriminates osteoporotic women with vertebral but not with hip fracture. Ultrasound Med Biol. 2004;30:357–361
  37. Gonnelli S, Cepollaro C, Agnusdei D, et al. Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenopausal women. Osteoporos Int. 1995;5:413–418
  38. Gonnelli S, Cepollaro C, Gennari L, et al. Quantitative ultrasound and dual-energy X-ray absorptiometry in the prediction of fragility fracture in men. Osteoporos Int. 2005;16:963–968
  39. Greenspan SL, Bouxsein ML, Melton ME, et al. Precision and discriminatory ability of calcaneal bone assessment technologies. J Bone Miner Res. 1997;12:1303–1313
  40. Greenspan SL, Cheng S, Miller PD, et al. Clinical performance of a highly portable, scanning calcaneal ultrasonometer. Osteoporos Int. 2001;12:391–398
  41. Guglielmi G, Njeh CF, de Terlizzi F, et al. Palangeal quantitative ultrasound, phalangeal morphometric variables, and vertebral fracture discrimination. Calcif Tissue Int. 2003;72:469–477
  42. Hadji P, Hars O, Gorke K, et al. Quantitative ultrasound of the os calcis in postmenopausal women with spine and hip fracture. J Clin Densitom. 2000;3:233–239
  43. Hamanaka Y, Yamamoto I, Takada M, et al. Comparison of bone mineral density at various skeletal sites with quantitative ultrasound parameters of the calcaneus for assessment of vertebral fractures. J Bone Miner Metab. 1999;17:195–200
  44. Hans D, Srivastav SK, Singal C, et al. Does combining the results from multiple bone sites measured by a new quantitative ultrasound device improve discrimination of hip fracture?. J Bone Miner Res. 1999;14:644–651
  45. Hans D, Allaoua S, Genton L, et al. Is time since hip fracture influencing the discrimination between fractured and nonfractured subjects as assessed at the calcaneum by three technologically different quantitative ultrasound devices?. Calcif Tissue Int. 2002;71:485–492
  46. Hans D, Genton L, Allaoua S, et al. Hip fracture discrimination study: QUS of the radius and the calcaneum. J Clin Densitom. 2003;6:163–172
  47. Hartl F, Tyndall A, Kraenzlin M, et al. Discriminatory ability of quantitative ultrasound parameters and bone mineral density in a population-based sample of postmenopausal women with vertebral fractures: results of the Basel Osteoporosis Study. J Bone Miner Res. 2002;17:321–330
  48. He YQ, Fan B, Hans D, et al. Assessment of a new quantitative ultrasound calcaneus measurement: precision and discrimination of hip fractures in elderly women compared with dual X-ray absorptiometry. Osteoporos Int. 2000;11:354–360
  49. Hernandez JL, Marin F, Gonzalez-Macias J, et al. Discriminative capacity of calcaneal quantitative ultrasound and of osteoporosis and fracture risk factors in postmenopausal women with osteoporotic fractures. Calcif Tissue Int. 2004;74:357–365
  50. Hollevoet N, Verdonk R, Goemaere S, et al. Tibial ultrasound velocity in women with wrist fracture. J Clin Densitom. 2004;7:302–306
  51. Ingle BM, Eastell R. Site-specific bone measurements in patients with ankle fracture. Osteoporos Int. 2002;13:342–347
  52. Karlsson MK, Duan Y, Ahlborg H, et al. Age, gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mineral density. Bone. 2001;28:118–122
  53. Knapp KM, Blake GM, Fogelman I, et al. Multisite quantitative ultrasound: Colles' fracture discrimination in postmenopausal women. Osteoporos Int. 2002;13:474–479
  54. Knapp KM, Blake GM, Spector TD, et al. Multisite quantitative ultrasound: precision, age- and menopause-related changes, fracture discrimination, and T-score equivalence with dual-energy X-ray absorptiometry. Osteoporos Int. 2001;12:456–464
  55. Krieg MA, Cornuz J, Ruffieux C, et al. Comparison of three bone ultrasounds for the discrimination of subjects with and without osteoporotic fractures among 7562 elderly women. J Bone Miner Res. 2003;18:1261–1266
  56. Kung AW, Luk KD, Chu LW, et al. Quantitative ultrasound and symptomatic vertebral fracture risk in Chinese women. Osteoporos Int. 1999;10:456–461
  57. Lopez-Rodriguez F, Mezquita-Raya P, de Dios Luna J, et al. Performance of quantitative ultrasound in the discrimination of prevalent osteoporotic fractures in a bone metabolic unit. Bone. 2003;32:571–578
  58. Maggi S, Noale M, Giannini S, et al. Quantitative heel ultrasound in a population-based study in Italy and its relationship with fracture history: the ESOPO study. Osteoporos Int. 2006;17:237–244
  59. Matsushita R, Yamamoto I, Takada M, et al. Comparison of various biochemical measurements with bone mineral densitometry and quantitative ultrasound for the assessment of vertebral fracture. J Bone Miner Metab. 2000;18:158–164
  60. Meszaros S, Toth E, Ferencz V, et al. Calcaneous quantitative ultrasound measurements predicts vertebral fractures in idiopathic male osteoporosis. Joint Bone Spine. 2007;74:79–84
  61. Mikhail MB, Flaster E, Aloia JF. Stiffness in discrimination of patients with vertebral fractures. Osteoporos Int. 1999;9:24–28
  62. Mulleman D, Legroux-Gerot I, Duquesnoy B, et al. Quantitative ultrasound of bone in male osteoporosis. Osteoporos Int. 2002;13:388–393
  63. Muraki S, Yamamoto S, Kanai H. Ultrasound velocity in the tibia in Japanese patients with hip fracture. J Orthop Sci. 2002;7:623–628
  64. Nguyen TV, Center JR, Eisman JA. Bone mineral density-independent association of quantitative ultrasound measurements and fracture risk in women. Osteoporos Int. 2004;15:942–947
  65. Ohishi T, Kushida K, Yamazaki K, et al. Ultrasound measurement using CUBA clinical system can discriminate between women with and without vertebral fractures. Contact Ultrasound Bone Analyzer. J Clin Densitom. 2000;3:227–231
  66. Peretz A, De Maertelaer V, Moris M, et al. Evaluation of quantitative ultrasound and dual X-Ray absorptiometry measurements in women with and without fractures. J Clin Densitom. 1999;2:127–133
  67. Pinheiro MM, Castro CH, Frisoli A, et al. Discriminatory ability of quantitative ultrasound measurements is similar to dual-energy X-ray absorptiometry in a Brazilian women population with osteoporotic fracture. Calcif Tissue Int. 2003;73:555–564
  68. Pluskiewicz W, Drozdzowska B. Ultrasound measurements at the calcaneus in men: differences between healthy and fractured persons and the influence of age and anthropometric features on ultrasound parameters. Osteoporos Int. 1999;10:47–51
  69. Ross P, Huang C, Davis J, et al. Predicting vertebral deformity using bone densitometry at various skeletal sites and calcaneus ultrasound. Bone. 1995;16:325–332
  70. Roux C, Roberjot V, Porcher R, et al. Ultrasonic backscatter and transmission parameters at the os calcis in postmenopausal osteoporosis. J Bone Miner Res. 2001;16:1353–1362
  71. Sakata S, Kushida K, Yamazaki K, et al. Ultrasound bone densitometry of os calcis in elderly Japanese women with hip fracture. Calcif Tissue Int. 1997;60:2–7
  72. Schneider J, Bundschuh B, Spath C, et al. Discrimination of patients with and without vertebral fractures as measured by ultrasound and DXA osteodensitometry. Calcif Tissue Int. 2004;74:246–254
  73. Schott AM, Weill-Engerer S, Hans D, et al. Ultrasound discriminates patients with hip fracture equally well as dual energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res. 1995;10:243–249
  74. Stegman MR, Heaney RP, Recker RR. Comparison of speed of sound ultrasound with single photon absorptiometry for determining fracture odds ratios. J Bone Miner Res. 1995;10:346–352
  75. Stewart A, Felsenberg D, Kalidis L, et al. Vertebral fractures in men and women: how discriminative are bone mass measurements?. Br J Radiol. 1995;68:614–620
  76. Travers-Gustafson D, Stegman MR, Heaney RP, et al. Ultrasound, densitometry, and extraskeletal appendicular fracture risk factors: a cross-sectional report on the Saunders County Bone Quality Study. Calcif Tissue Int. 1995;57:267–271
  77. Turner CH, Peacock M, Timmerman L, et al. Calcaneal ultrasonic measurements discriminate hip fracture independently of bone mass. Osteoporos Int. 1995;5:130–135
  78. Varenna M, Sinigaglia L, Adami S, et al. Association of quantitative heel ultrasound with history of osteoporotic fractures in elderly men: the ESOPO study. Osteoporos Int. 2005;16:1749–1754
  79. Weiss M, Ben-Shlomo A, Hagag P, et al. Discrimination of proximal hip fracture by quantitative ultrasound measurement at the radius. Osteoporos Int. 2000;11:411–416
  80. Welch A, Camus J, Dalzell N, et al. Broadband ultrasound attenuation (BUA) of the heel bone and its correlates in men and women in the EPIC-Norfolk cohort: a cross-sectional population-based study. Osteoporos Int. 2004;15:217–225
  81. Wuster C, Albanese C, De Aloysio D, et al. Phalangeal osteosonogrammetry study: age-related changes, diagnostic sensitivity, and discrimination power. The Phalangeal Osteosonogrammetry Study Group. J Bone Miner Res. 2000;15:1603–1614
  82. Porter RW, Miller CG, Grainger D, et al. Prediction of hip fracture in elderly women: a prospective study. Bmj. 1990;301:638–641
  83. Heaney RP, Avioli LV, Chesnut CH, et al. Ultrasound velocity, through bone predicts incident vertebral deformity. J Bone Miner Res. 1995;10:341–345
  84. Hans D, Dargent-Molina P, Schott AM, et al. Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study. Lancet. 1996;348:511–514
  85. Bauer DC, Gluer CC, Cauley JA, et al. Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1997;157:629–634
  86. Pluijm SM, Graafmans WC, Bouter LM, et al. Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. Osteoporos Int. 1999;9:550–556
  87. Fujiwara S, Sone T, Yamazaki K, et al. Heel bone ultrasound predicts non-spine fracture in Japanese men and women. Osteoporos Int. 2005;16:2107–2112
  88. Schott AM, Hans D, Duboeuf F, et al. Quantitative ultrasound parameters as well as bone mineral density are better predictors of trochanteric than cervical hip fractures in elderly women. Results from the EPIDOS study. Bone. 2005;37:858–863
  89. Gluer MG, Minne HW, Gluer CC, et al. Prospective identification of postmenopausal osteoporotic women at high vertebral fracture risk by radiography, bone densitometry, quantitative ultrasound, and laboratory findings: results from the PIOS study. J Clin Densitom. 2005;8:386–395
  90. Krieg MA, Cornuz J, Ruffieux C, et al. Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or = 70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study. J Bone Miner Res. 2006;21:1457–1463
  91. Diez-Perez A, Gonzalez-Macias J, Marin F, et al. Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound. Osteoporos Int. 2007;18:629–639
  92. Bauer DC, Ewing SK, Guley JA, et al. Quantitative ultrasound predicts hip and non-spine fracture in men: the MrOS study. Osteoporos Int. 2007;18:771–777
  93. Stewart A, Torgerson DJ, Reid DM. Prediction of fractures in perimenopausal women: a comparison of dual energy X ray absorptiometry and broadband ultrasound attenuation. Ann Rheum Dis. 1996;55:140–142
  94. Mele R, Masci G, Ventura V, et al. Three-year longitudinal study with quantitative ultrasound at the hand phalanx in a female population. Osteoporos Int. 1997;7:550–557
  95. Huang C, Ross PD, Yates AJ, et al. Prediction of fracture risk by radiographic absorptiometry and quantitative ultrasound: a prospective study. Calcif Tissue Int. 1998;63:380–384
  96. Thompson PW, Taylor J, Oliver R, et al. Quantitative ultrasound (QUS) of the heel predicts wrist and osteoporosis-related fractures in women age 45–75 years. J Clin Densitom. 1998;1:219–225
  97. Gnudi S, Ripamonti C, Malavolta N. Quantitative ultrasound and bone densitometry to evaluate the risk of nonspine fractures: a prospective study. Osteoporos Int. 2000;11:518–523
  98. Miller PD, Siris ES, Barrett-Connor E, et al. Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res. 2002;17:2222–2230
  99. Huopio J, Kroger H, Honkanen R, et al. Calcaneal ultrasound predicts early postmenopausal fractures as well as axial BMD. A prospective study of 422 women. Osteoporos Int. 2004;15:190–195
  100. Khaw KT, Reeve J, Luben R, et al. Prediction of total and hip fracture risk in men and women by quantitative ultrasound of the calcaneus: EPIC-Norfolk prospective population study. Lancet. 2004;363:197–202
  101. Devine A, Dick IM, Dhaliwal SS, et al. Prediction of incident osteoporotic fractures in elderly women using the free estradiol index. Osteoporos Int. 2005;16:216–221
  102. Stewart A, Kumar V, Reid DM. Long-term fracture prediction by DXA and QUS: a 10-year prospective study. J Bone Miner Res. 2006;21:413–418
  103. Pinheiro MM, Castro CM, Szejnfeld VL. Low femoral bone mineral density and quantitative ultrasound are risk factors for new osteoporotic fracture and total and cardiovascular mortality: a 5-year population-based study of Brazilian elderly women. J Gerontol A Biol Sci Med Sci. 2006;61:196–203
  104. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Bmj. 1996;312:1254–1259
  105. Durosier C, Hans D, Krieg MA, et al. Prediction and discrimination of osteoporotic hip fracture in postmenopausal women. J Clin Densitom. 2006;9:475–495
  106. McGrother CW, Donaldson MM, Clayton D, et al. Evaluation of a hip fracture risk score for assessing elderly women: the Melton Osteoporotic Fracture (MOF) study. Osteoporos Int. 2002;13:89–96
  107. National Osteoporosis Society . Position statement on the use of peripheral x-ray absorptiometry in the management of osteoporosis. Bath, England: National Osteoporosis Society; 2004;
  108. Gluer C, Barkmann R, Blenk T, et al. Quantitative ultrasound predicts incident vertebral and hip fractures at least as strongly as DXA: the OPUS study. abstract J Bone Miner Res. 2007;22(Suppl 1):1075
  109. Hartl F, Hans D, Hollaender R, et al. Prospective evaluation of risk of vertebral fractures using quantitative ultrasound measurements and bone mineral density in a population-based sample of postmenopausal women: results of the BOS study. J Bone Miner Res. 2005;20(Suppl 1):SU166
  110. Dobnig H, Piswanger-Solkner JC, Obermayer-Pietsch B, et al. Hip and nonvertebral fracture prediction in nursing home patients: role of bone ultrasound and bone marker measurements. J Clin Endocrinol Metab. 2007;92:1678–1686
  111. Krieg MA, Hans D. Quantitative ultrasound and hip fractures?. J Bone Miner Res. 2007;22:1312
  112. Frost ML, Blake GM, Fogelman I. Can the WHO criteria for diagnosing osteoporosis be applied to calcaneal quantitative ultrasound?. Osteoporos Int. 2000;11:321–330
  113. Faulkner KG, von Stetten E, Miller P. Discordance in patient classification using T-scores. J Clin Densitom. 1999;2:343–350
  114. Damilakis J, Perisinakis K, Gourtsoyiannis N. Imaging ultrasonometry of the calcaneus: optimum T-score thresholds for the identification of osteoporotic subjects. Calcif Tissue Int. 2001;68:219–224
  115. Knapp KM, Blake GM, Spector TD, et al. Can the WHO definition of osteoporosis be applied to multi-site axial transmission quantitative ultrasound?. Osteoporos Int. 2004;15:367–374
  116. Hans D, Rizzoli R, Thiebaud D, et al. Reference data in a Swiss population. Discordance in patient classification using T-scores among calcaneum, spine, and femur. J Clin Densitom. 2001;4:291–298
  117. Black G, Fordham JN, McCrea JD, et al., and The NOS Bone Densitometry Forum and the NOS Scientific Advisory Group. 2004. Position statement on the use of peripheral x-ray absorptiometry in the management of osteoporosis.
  118. Black G, Chinn D, Steel S, et al., 2007. The revised NOS position statement on peripheral x-ray absorptiometry: a listing of device specific T-score thresholds for the clinical interpretation of pDXA examinations. Available at: http://www.nos.org.uk. Accessed January 17, 2008.
  119. Hans D, Hartl F, Krieg MA. Device-specific weighted T-score for two quantitative ultrasounds: operational propositions for the management of osteoporosis for 65 years and older women in Switzerland. Osteoporos Int. 2003;14:251–258
  120. Clowes JA, Peel NF, Eastell R. Device-specific thresholds to diagnose osteoporosis at the proximal femur: an approach to interpreting peripheral bone measurements in clinical practice. Osteoporos Int. 2006;17:1293–1302
  121. Davson-Hughes B and the expert committee of the National Osteoporosis Foundation. 2003. Phyisician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, DC.
  122. Neff MJ. Practice guideline: ACOG releases guidelines for clinical of osteoporosis. Am Fam Physician. 2004;69:1558–1560
  123. Cobin RH The AACE Menopause Guidelines Revision Task Force. Medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocr Pract. 2006;12:316–337
  124. Anonymous . Management of osteoporosis: a national clinical guideline. updated 2004 Scottish Intercollegiate Guidelines Network; 2003;Available at: http://www.sign.ac.uk/Accessed: January 17, 2008
  125. NAMS . Management of osteoporosis in postmenopausal women: 2006 position statement of The North American Menopause Society. Menopause. 2006;13:340–367
  126. DVO . 2006 DVO—Guidelines for prevention, diagnosis, and therapy of osteoporosis for women after menopause, for men after age 60: executive summary. Dachverband Osteologie e.V; 2006;Available at: http://www.lutherhaus.de/osteo/leitlinien-dvo/index.phpAccessed January 17, 2008
  127. Brown JP, Fortier M. Canadian Consensus Conference on Osteoporosis, update 2006. 172. SOGC Clinical Practice Guideline; 2006;S95–S112
  128. Anonymous . AFSSAPS: Traitement médicamenteux de l'ostéoporose post-ménopausique. Recommandations. www.afssaps-sante-fr2006;Available at:
  129. Lyles KW, Colon-Emeric CS, Magaziner JS, et al. Zoledronic Acid and Clinical Fractures and Mortality after Hip Fracture. N Engl J Med. 2007;357:1799–1809
  130. Roux C, Fournier B, Laugier P, et al. Broadband ultrasound attenuation imaging: a new imaging method in osteoporosis. J Bone Miner Res. 1996;11:1112–1118
  131. Hans D, Arlot ME, Schott AM, et al. Do ultrasound measurements on the os calcis reflect more the bone microarchitecture than the bone mass?: a two-dimensional histomorphometric study. Bone. 1995;16:295–300
  132. Krieg MA, Thiebaud D, Landry M, et al. Evaluation of bones using quantitative ultrasonography. Schweiz Med Wochenschr. 1996;126:159–163
  133. Seeman E, Delmas PD. Bone quality—the material and structural basis of bone strength and fragility. N Engl J Med. 2006;354:2250–2261
  134. Bouxsein ML. Mechanisms of osteoporosis therapy: a bone strength perspective. Clin Cornerstone Suppl. 2003;2:S13–S21
  135. Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporos Int 14 Suppl. 2003;3:S13–S18
  136. Hans D, Wu C, Njeh CF, et al. Ultrasound velocity of trabecular cubes reflects mainly bone density and elasticity. Calcif Tissue Int. 1999;64:18–23
  137. Hans D, Fuerst T, Uffmann M. Bone density and quality measurement using ultrasound. Curr Opin Rheumatol. 1996;8:370–375
  138. Gluer CC, Wu CY, Genant HK. Broadband ultrasound attenuation signals depend on trabecular orientation: an in vitro study. Osteoporos Int. 1993;3:185–191
  139. Gluer CC, Wu CY, Jergas M, et al. Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int. 1994;55:46–52
  140. Bouxsein ML, Coan BS, Lee SC. Prediction of the strength of the elderly proximal femur by bone mineral density and quantitative ultrasound measurements of the heel and tibia. Bone. 1999;25:49–54
  141. Bouxsein ML, Radloff SE. Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone. J Bone Miner Res. 1997;12:839–846
  142. Cheng XG, Nicholson PH, Boonen S, et al. Prediction of vertebral strength in vitro by spinal bone densitometry and calcaneal ultrasound. J Bone Miner Res. 1997;12:1721–1728
  143. Lochmuller EM, Burklein D, Kuhn V, et al. Mechanical strength of the thoracolumbar spine in the elderly: prediction from in situ dual-energy X-ray absorptiometry, quantitative computed tomography (QCT), upper and lower limb peripheral QCT, and quantitative ultrasound. Bone. 2002;31:77–84
  144. Lochmuller EM, Lill CA, Kuhn V, et al. Radius bone strength in bending, compression, and falling and its correlation with clinical densitometry at multiple sites. J Bone Miner Res. 2002;17:1629–1638
  145. Hakulinen MA, Toyras J, Saarakkala S, et al. Ability of ultrasound backscattering to predict mechanical properties of bovine trabecular bone. Ultrasound Med Biol. 2004;30:919–927
  146. Han S, Medige J, Faran K, et al. The ability of quantitative ultrasound to predict the mechanical properties of trabecular bone under different strain rates. Med Eng Phys. 1997;19:742–747
  147. Njeh CF, Kuo CW, Langton CM, et al. Prediction of human femoral bone strength using ultrasound velocity and BMD: an in vitro study. Osteoporos Int. 1997;7:471–477
  148. Kanis JA, Oden A, Johnell O, et al. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int. 2007;18:1033–1046
  149. Dargent-Molina P, Piault S, Breart G. A triage strategy based on clinical risk factors for selecting elderly women for treatment or bone densitometry: the EPIDOS prospective study. Osteoporos Int. 2005;16:898–906
  150. Schott AM, Kassai Koupai B, Hans D, et al. Should age influence the choice of quantitative bone assessment technique in elderly women? The EPIDOS study. Osteoporos Int. 2004;15:196–203
  151. De Laet C, Kanis JA, Oden A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005;16:1330–1338
  152. Durosier C, Hans D, Krieg MA, et al. Combining clinical factors and quantitative ultrasound improves the detection of women both at low and high risk for hip fracture. Osteoporos Int. 2007;18:1651–1659
  153. Kanis JA, Johnell O, De Laet C, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35:375–382
  154. Kanis JA, Johansson H, Oden A, et al. A family history of fracture and fracture risk: a meta-analysis. Bone. 2004;35:1029–1037
  155. Kanis JA, Johnell O, Oden A, et al. Smoking and fracture risk: a meta-analysis. Osteoporos Int. 2005;16:155–162
  156. Kanis JA, Johansson H, Oden A, et al. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res. 2004;19:893–899
  157. Dargent-Molina P, Favier F, Grandjean H, et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet. 1996;348:145–149
  158. Black DM, Steinbuch M, Palermo L, et al. An assessment tool for predicting fracture risk in postmenopausal women. Osteoporos Int. 2001;12:519–528
  159. Hans D, Schott AM, Durosier C, et al. 10 year probability of osteoporotic hip fracture in 12958 elderly women combining clinical factors and hell bone ultrasound: the combined “SEMOF + EPIDOS” prospective cohorts. J Bone Miner Res. 2006;21:S55
  160. Haiat G, Padilla F, Peyrin F, Laugier P. Variation of ultrasonic parameters with microstructure and material properties of trabecular bone: a 3D model simulation. J Bone Miner Res. 2007;22:665–674
  161. Jenson F, Padilla F, Bousson V, et al. In vitro ultrasonic characterization of human cancellous femoral bone using transmission and backscatter measurements: relationships to bone mineral density. J Acoust Soc Am. 2006;119:654–663
  162. Sakata S, Barkmann R, Lochmuller EM, et al. Assessing bone status beyond BMD: evaluation of bone geometry and porosity by quantitative ultrasound of human finger phalanges. J Bone Miner Res. 2004;19:924–930
  163. Barkmann R, Lusse S, Stampa B, et al. Assessment of the geometry of human finger phalanges using quantitative ultrasound in vivo. Osteoporos Int. 2000;11:745–755
  164. Lee SC, Coan BS, Bouxsein ML. Tibial ultrasound velocity measured in situ predicts the material properties of tibial cortical bone. Bone. 1997;21:119–125
  165. Muller ME, Webber CE, Bouxsein ML. Predicting the failure load of the distal radius. Osteoporos Int. 2003;14:345–352
  166. Naessen T, Mallmin H, Ljunghall S. Heel ultrasound in women after long-term ERT compared with bone densities in the forearm, spine and hip. Osteoporos Int. 1995;5:205–210
  167. Gonnelli S, Cepollaro C, Montagnani A, et al. Alendronate treatment in men with primary osteoporosis: a three-year longitudinal study. Calcif Tissue Int. 2003;73:133–139
  168. Gonnelli S, Cepollaro C, Montagnani A, et al. Heel ultrasonography in monitoring alendronate therapy: a four-year longitudinal study. Osteoporos Int. 2002;13:415–421
  169. Gonnelli S, Cepollaro C, Pondrelli C, et al. Ultrasound parameters in osteoporotic patients treated with salmon calcitonin: a longitudinal study. Osteoporos Int. 1996;6:303–307
  170. Gonnelli S, Martini G, Caffarelli C, et al. Teriparatide's effects on quantitative ultrasound parameters and bone density in women with established osteoporosis. Osteoporos Int. 2006;17:1524–1531
  171. Krieg MA, Jacquet AF, Bremgartner M, et al. Effect of supplementation with vitamin D3 and calcium on quantitative ultrasound of bone in elderly institutionalized women: a longitudinal study. Osteoporos Int. 1999;9:483–488
  172. Sahota O, San P, Cawte SA, et al. A comparison of the longitudinal changes in quantitative ultrasound with dual-energy X-ray absorptiometry: the four-year effects of hormone replacement therapy. Osteoporos Int. 2000;11:52–58
  173. Hadji P, Hars O, Schuler M, et al. Assessment by quantitative ultrasonometry of the effects of hormone replacement therapy on bone mass. Am J Obstet Gynecol. 2000;182:529–534
  174. Balikian P, Burbank K, Houde J, et al. Bone mineral density and broadband ultrasound attenuation with estrogen treatment of postmenopausal women. J Clin Densitom. 1998;1:19–26
  175. Frost ML, Blake GM, Fogelman . Changes in QUS and BMD measurements with antiresorptive therapy: a two-year longitudinal study. Calcif Tissue Int. 2001;69:138–146
  176. Moschonis G, Manios Y. Skeletal site-dependent response of bone mineral density and quantitative ultrasound parameters following a 12-month dietary intervention using dairy products fortified with calcium and vitamin D: the Postmenopausal Health Study. Br J Nutr. 2006;96:1140–1148
  177. de Aloysio D, Rovati LC, Cadossi R, et al. Bone effects of transdermal hormone replacement therapy in postmenopausal women as evaluated by means of ultrasound: an open one-year prospective study. Maturitas. 1997;27:61–68
  178. Mauloni M, Rovati LC, Cadossi R, et al. Monitoring bone effect of transdermal hormone replacement therapy by ultrasound investigation at the phalanx: a four-year follow-up study. Menopause. 2000;7:402–412
  179. Zitzmann M, Brune M, Vieth V, et al. Monitoring bone density in hypogonadal men by quantitative phalangeal ultrasound. Bone. 2002;31:422–429
  180. Seriolo B, Paolino S, Sulli A, et al. Bone metabolism changes during anti-TNF-alpha therapy in patients with active rheumatoid arthritis. Ann N Y Acad Sci. 2006;1069:420–427
  181. Drake WM, Brown JP, Banville C, et al. Use of phalangeal bone mineral density and multi-site speed of sound conduction to monitor therapy with alendronate in postmenopausal women. Osteoporos Int. 2002;13:249–256
  182. Knapp KM, Andrew T, MacGregor AJ, et al. An investigation of unique and shared gene effects on speed of sound and bone density using axial transmission quantitative ultrasound and DXA in twins. J Bone Miner Res. 2003;18:1525–1530
  183. Ingle BM, Machado AB, Pereda CA, et al. Monitoring alendronate and estradiol therapy with quantitative ultrasound and bone mineral density. J Clin Densitom. 2005;8:278–286
  184. Anonymous . Indications and reporting for dual-energy x-ray absorptiometry. J Clin Densitom. 2004;7:37–44
  185. Fuerst T, Njeh CF, Hans D. Quality assurance and quality control in quantitative ultrasound. In:  Njeh CF,  Hans D,  Fuerst T,  Gluer C,  Genant HK editor. Quantitative ultrasound: Assessment of osteoporosis and bone status. London: Martin Dunitz; 1999;p. 163–175
  186. Bennett HS, Dienstfrey A, Hudson LT, et al. Standards and measurements for assessing bone health-workshop report co-sponsored by the International Society for Clinical Densitometry (ISCD) and the National Institute of Standards and Technology (NIST). J Clin Densitom. 2006;9:399–405
  187. Engelke K, Gluer CC. Quality and performance measures in bone densitometry: part 1: errors and diagnosis. Osteoporos Int. 2006;17:1283–1292
  188. Khan AA, Colquhoun A, Hanley DA, et al. Standards and guidelines for technologists performing central dual-energy X-ray absorptiometry. J Clin Densitom. 2007;10:189–195
  189. Lewiecki EM, Binkley N, Bilezikian JP, et al. Official positions of the International Society for Clinical Densitometry. Osteoporos Int. 2006;17:1700–1701
  190. Lewiecki EM, Binkley N, Petak SM. DXA quality matters. J Clin Densitom. 2006;9:388–392
  191. Shepherd JA, Lu Y, Wilson K, et al. Cross-calibration and minimum precision standards for dual-energy X-ray absorptiometry: the 2005 ISCD Official Positions. J Clin Densitom. 2006;9:31–36
  192. Evans WD, Jones EA, Owen GM. Factors affecting the in vivo precision of broad-band ultrasonic attenuation. Phys Med Biol. 1995;40:137–151
  193. Chappard C, Berger G, Roux C, et al. Ultrasound measurement on the calcaneus: influence of immersion time and rotation of the foot. Osteoporos Int. 1999;9:318–326
  194. Paggiosi MA, Blumsohn A, Barkmann R, et al. Effect of temperature on the longitudinal variability of quantitative ultrasound variables. J Clin Densitom. 2005;8:436–444
  195. Hans D, Wacker W, Genton L, et al. Longitudinal quality control methodology for the quantitative ultrasound Achilles+ in clinical trial settings. Osteoporos Int. 2002;13:788–795
  196. Njeh CF, Richards A, Boivin CM, et al. Factors influencing the speed of sound through the proximal phalanges. J Clin Densitom. 1999;2:241–249
  197. Barkmann R, Gluer C. Error sources in quantitative ultrasound measurement. In:  Njeh CF,  Hans D,  Fuerst T,  Gluer C,  Genant H editor. Quantitative ultrasound: Assessment of osteoporosis and bone status. London: Martin Dunitz; 1999;p. 101–107
  198. Cheng S, Njeh CF, Fan B, et al. Influence of region of interest and bone size on calcaneal BMD: implications for the accuracy of quantitative ultrasound assessments at the calcaneus. Br J Radiol. 2002;75:59–68
  199. Hans D, Schott AM, Arlot ME, et al. Influence of anthropometric parameters on ultrasound measurements of Os calcis. Osteoporos Int. 1995;5:371–376
  200. Laugier P, Giat P, Berger G. Broadband ultrasonic attenuation imaging: a new imaging technique of the os calcis. Calcif Tissue Int. 1994;54:83–86
  201. Ikeda Y, Iki M. Precision control and seasonal variations in quantitative ultrasound measurement of the calcaneus. J Bone Miner Metab. 2004;22:588–593
  202. Iki M, Kajita E, Mitamura S, et al. Precision of quantitative ultrasound measurement of the heel bone and effects of ambient temperature on the parameters. Osteoporos Int. 1999;10:462–467
  203. Kotzki PO, Buyck D, Hans D, et al. Influence of fat on ultrasound measurements of the os calcis. Calcif Tissue Int. 1994;54:91–95
  204. Chappard C, Camus E, Lefebvre F, et al. Evaluation of error bounds on calcaneal speed of sound caused by surrounding soft tissue. J Clin Densitom. 2000;3:121–131
  205. Johansen A, Stone MD. The effect of ankle oedema on bone ultrasound assessment at the heel. Osteoporos Int. 1997;7:44–47
  206. Laugier P, Fournier B, Berger G. Ultrasound parametric imaging of the calcaneus: in vivo results with a new device. Calcif Tissue Int. 1996;58:326–331
  207. Langton CM. Development of an electronic phantom for calibration, cross-correlation, ans quality assurance of BUA measurement in the calcaneus. Osteoporos Int. 1997;7:309
  208. Hans D, Alekxandrova I, Njeh C, et al. Appropriateness of internal digital phantoms for monitoring the stability of the UBIS 5000 quantitative ultrasound device in clinical trials. Osteoporos Int. 2005;16:435–445
  209. Krieg MA, Cornuz J, Hartl F, et al. Quality controls for two heel bone ultrasounds used in the Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk Study. J Clin Densitom. 2002;5:335–341

PII: S1094-6950(07)00259-4

doi: 10.1016/j.jocd.2007.12.011

Journal of Clinical Densitometry
Volume 11, Issue 1 , Pages 163-187 , January 2008