Screening for low bone mineral density with quantitative ultrasound within the primary health care system

Abstract

Objective – To screen risk groups for low bone mineral density by quantitative ultrasound in primary health care.Design – Cross-sectional.Intervention – None.Subjects − Risk categories for osteoporosis (a fragility fracture, malabsorption, immobilisation, inflammatory joint disease, glucocorticoid, fenantoin or thyroxin treatment, renal insufficiency or “miscellaneous”), 775 women and 179 men aged between 40 and 93 were measured.Main outcome measures – Calcaneus quantitative ultrasound stiffness index T-score below −2.5 standard deviation (SD).Results – 41% of women and 24% of men and more than 80% of women and 50% of men over the age of 80, within the risk groups, had a stiffness index T-score below −2.5 SD. All over 80 years with a fragility fracture had a stiffness index T-score below −2.5 SD. Men aged 50–59 within the risk groups had lower stiffness index T-scores than controls (−1.4 versus −0.6, p=0.05). Individuals with a fragility fracture had lower stiffness index T-scores than controls, women aged 70–79 years (−3.1 versus −2.4, p<0.05) and men aged 60–69 years (−2.3 versus −1.2, p<0.05).Conclusion – Quantitative ultrasound calcaneus used in gender-specific, diagnosis-specific and age-specific cohorts can capture individuals with low bone mass.