[Ultrasound measurement of calcaneus: a promising method for prediction of osteoporotic fractures]

When carrying out quantitative ultrasound (QUS) measurements of the calcaneus, broadband ultrasound attenuation (BUA, in dB/MHz) and speed of sound (SOS, in m/s) are assessed. From in vitro studies it is known that the mechanical properties of trabecular bone (stiffness and strength) can be better predicted with QUS than with dual energy X-ray absorptiometry (DEXA). Bone mineral density (BMD) measurements with DEXA are currently used for the diagnosis of osteoporosis according to the WHO criteria. There is no consensus regarding the diagnosis of osteoporosis with QUS measurements of the calcaneus. In prospective studies in women of 65 years and older it has been shown that fracture risk assessment with QUS measurements is feasible. The value of QUS measurements for the follow-up of patients with skeletal disorders is not yet known. At present there are important differences between ultrasound devices and there is no standardisation. The development of quality standards for and cross-calibrations of QUS scanners is necessary, so that results from different devices can be compared. Although QUS of the calcaneus is a promising method for the prediction of osteoporotic fractures, its routine use in clinical practice cannot yet be recommended.