Phalangeal Osteosonogrammetry Study: Age‐Related Changes, Diagnostic Sensitivity, and Discrimination Power

• Published in: Journal of bone and mineral research Vol. 15; no. 8; pp. 1603 - 1614
• Main Authors: Wüster, C., Albanese, C., De aloysio, D., Duboeuf, F., Gambacciani, M., Gonnelli, S., Glüer, C. C., Hans, D., Joly, J., Reginster, J. Y., De Terlizzi, F., Cadossi, R.
• Format: Journal Article
• Language: English
• Published: Washington, DC John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR) 01.08.2000; American Society for Bone and Mineral Research
• Subjects: Biological and medical sciences; bone; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Miscellaneous. Technology; osteoporosis; phalanges; phalanx; signal processing; Ultrasonic investigative techniques; ultrasound; Sonography; Human; Methodology; Diseases of the osteoarticular system; Bone disease; Osteoarticular system; Osteoporosis; Signal processing; Bone; Densitometry; Diagnosis; Measurement method; Phalanx; Age
• ISSN: 0884-0431; 1523-4681
• DOI: 10.1359/jbmr.2000.15.8.1603

Phalangeal osteosonogrammetry was introduced as a method for bone tissue investigation in 1992. It is based on the measure of the velocity of ultrasound (amplitude‐dependent speed of sound [AD‐SoS]) and on the interpretation of the characteristics of the ultrasound signal. In this study we have collected a database of 10,115 subjects to evaluate the performance of AD‐SoS and to develop a parameter that is able to quantify the signal characteristics: ultrasound bone profile index (UBPI). The database only includes females of which 4.5% had documented vertebral osteoporotic fractures, 16% lumbar spine dual X‐ray absorptiometry (DXA), and 6% hip DXA. The analysis of the ultrasound signal has shown that with aging the UBPI, first wave amplitude (FWA), and signal dynamics (SDy) follow a trend that is different from the one observed for AD‐SoS; that is, there is no increase during childhood. In the whole population, the risk of fracture per SD decrease for AD‐SOS was odds ratio (OR) 1.71 (CI, 1.58‐1.84). The AD‐SoS in fractured subjects was significantly lower than in a group of age‐matched nonfractured subjects (p < 0.0001). In a small cohort of hip‐fractured patients UBPI proved to be lower than in a control age‐matched group (p < 0.0001). When the World Health Organization (WHO) working group criteria were applied to this population to identify the T score value for osteoporosis, for AD‐SoS we found a T score of −3.2 and for UBPI we found a T score of −3.14. Sixty‐six percent of vertebral fractures were below the AD‐SoS −3.2 T score and 62% were below UBPI −3.14. We observed the highest incidence of fractures (63.6%) among subjects with AD‐SoS who had both DXA T score values below the threshold. We conclude from this study that ultrasound investigation at the hand phalanges is a valid methodology for osteoporosis assessment. It has been possible to quantify signal changes by means of UBPI, a parameter that will improve the possibility of investigating bone structure.