Evaluation of osteoporosis using calcaneal QUS and FRAX score as a screening tool in a semi urban tertiary care hospital of South India

Abstract

Background: Osteoporosis is a silent, often found late, underdiagnosed disease characterized by low bone mass leading to increased susceptibility to fractures. With an increasingly aging population, the proportion of patients with osteopenia and osteoporosis are increasing in both developed and developing countries. The available data on osteoporosis is scanty from India. Methods: The objective was to measure the bone mineral density (BMD) of the patients using calcaneal Quantitative Ultrasound (QUS) and determine the risk factors along with the FRAX score. This was a hospital based cross sectional study conducted in a tertiary care hospital done on 183 out patients. BMD was measured using calcaneal QUS & T scores were calculated along with the FRAX score. Results: The prevalence of osteoporosis was 29.5% and osteopenia was 42.1%.The age wise analysis of BMD revealed males have the tendency to lose their bone mass after the age of 40 years while in females, the trend begins a decade earlier. The mean BMD of post-menopausal females was significantly lower compared to pre-menopausal females (-2.72 ± 1.33 vs -1.63 ± 1.06, P < 0.0001).Linear regression analysis revealed a complex linear relationship between the FRAX score and the BMD and it was statistically significant. Conclusions: Calcaneal QUS can be used as a screening tool to screen for and detect osteoporosis. It is economical, portable and easily available in many parts of the country. DEXA scan, the gold standard test to diagnose osteoporosis can be used to confirm the diagnosis in selected cases.