Ultrasound in Bone Quality Screening: From the Perspective of Osteoporosis

Background: Among Brazilians, 4.4% of population has osteoporosis, and the characteristic population with the disease is women above 45 years. Monitoring bone mineralization from an early age becomes a preventive factor essential for those with a family history of osteoporosis or vulnerable population to develop osteoporosis. It is essential to use techniques that are affordable and easily available with high reliability. Quantitative ultrasound (QUS) can be one of these techniques. Objectives: The objective of the study was to analyze the importance of phalanx ultrasound (US) as a tracking element of the bone quality, accurately establish the diagnostic tests as bone quality, define a nomogram of bone quality, build bone quality normality curve, and establish the pathological risk cutoff score according to the age group. Method: In this descriptive, analytical, cross-sectional study, 125 women who met the inclusion criteria were selected. They were divided into four groups according to their age: group 1 (G1): 30 to 39 years; group 2 (G2): 40 to 49 years; group 3 (G3): 50 to 59 years; and group 4 (G4): 60 years and above. All the participants underwent phalanx US and dual-energy X-ray absorptiometry (DEXA). The Ultrasound Bone Profile Index (UBPI) was found, and the phalanx US and sensitivity of the same technique were determined. Result: UBPI at the phalanx was compared with DEXA, and the sensitivity of the test was found to be 80% for G1 and 100% for G2, G3, and G4. Regarding femur DEXA, the sensitivity of the test was 90% for G1 and 100% for G2, G3, and G4. There was a significant inverse correlation observed between age and bone quality. This result includes an early decrease in bone quality, starting in the fertile period of women. The cutoff score for pathological risk was as follows: G1: 0.68 ± 0.23; G2: 0.64 ± 0.28; G3: 0.54 ± 0.37; and G4: 0.32 ± 0.30. Conclusion: Phalanx US proved to be a highly effective method as an osteoporosis tracking element in terms of bone quality evaluation, hence can be used as a screening tool for early diagnosis among the female population.