Manifold methods for bone mineral density analyses are introduced in this paper, and the characteristics of precision, accuracy, position, convenience, sensitivity and the radiation hazards of these methods are also discussed here.
Absorptiometry, Photon ; methods ; Bone Density ; Humans ; Osteoporosis ; diagnosis ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography ; instrumentation

BACKGROUND: Osteoporosis is developed by progressive decrease of bone rnass from decreased collagen content of bone. Accurate measurement of bone collagen is necessary for the diagnosis of osteoporosis and it is possible by bone biopsy, however bone biopsy is not easy in clinical practice. Skin collagen is consist with type I collagen which is same type of bone collagen and progressive decrease of bone collagen is reflected by decrease of skin collagen. Since skin thickness reflect skin collagen amount, skin thickness measurement may be a useful method for the evaluation of osteoporosis. So ultrasonic skin thickness measurement was developed for the evaluation of osteoporosis. METHODS: A randomly selected 200 women aged fram 30 to 71 years old were asked to have their skin thickness measured as well as lumbar vertebral DXA(Norland, USA) bone densitometry. Except for the two women who failed to complete the study, 45(22.7%) of these women were diagnosed as normal, 74(37.4%) were osteopenic and 79(39.9%) were diagnosed as osteoporosis patients using the WHO criteria. Skin thickness was measured using 20MHz Osteoson DCIII (Minhorst, Germany) at the medial side of the upper arm. A minimal of Two scans were measured and the mean value was cakulated automatically. RESULTS: The correlation coefficient of skin thickness and age was -0.121(ns), DXA BMD(bone mineral density) and age was -0.420(P<0.01), skin thickness and DXA BMD L2-L4 was 0.181(P<0.05). Skin thickness was significantly correlated with body weight(correlation coefficient 0.254, P<0.01) and BMI(correlation coefficient 0.195, P<0.01). Furthermore, the mean and standard deviation of skin thickness in normal BMD group was 0.94+-0.021mm, osteopenic group was 0.92+-0.006mm, and osteoporotic group was 0.89+-0.018mm. There was statistically significant difference in the mean values of skin thickness between the three groups even adjusted with age and BMI(P<0.05). The mean and standard deviation of skin tbickness of healthy 20-40 year old women was 1.11+-0,023mm and their mean and standard deviation of L2-L4 mean BMD was 1.17+-0.145mg/cm2. The diagnostic predictability of skin thickness less than 1mm as the risk of osteoporosis(BMD T score less than -1.0) was evaluated. The sensitivity and the specificity of skin thickness less than 1mm being osteoporotic were 78,2% and 57.8% respectively. The positive and negative predictive value of the skin thickness less than 1mm being osteoporotic were 82.2% and 36.5% respectively. CONCLUSION: This study indicate that the skin thickaess measured with the ultrasound method show good correlatian with the bone density measured with conventional DXA at the lumbar vertebra and the skin thickness less than 1mm on the medial side of the opper arm is relatively sensitive in diagnosing osteoporosis risk in Korean women. The authors suggested that a large randomized control study to define the relationship between the skin thickness and the other determinants of bone turnover in the near future.
Aged ; Arm ; Biopsy ; Bone Density ; Collagen ; Collagen Type I ; Densitometry ; Diagnosis* ; Female ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Sensitivity and Specificity ; Skin* ; Spine ; Ultrasonics ; Ultrasonography

This prospective intervention study was undertaken to estimate the prevalence and treatment rate of osteoporosis following osteoporosis screening tests in the same cohort. From November 1, 2014 to August 31, 2015, participants received screening tests for osteoporosis using ultrasound bone densitometry and education concerning osteoporosis and related conditions. The participants were interviewed using a questionnaire on the diagnosis and initiation of osteoporosis treatment during the follow-up period. Of 960 potential participants, 595 people (68.8%; 150 men and 445 women) were given bone densitometry measurements and completed the questionnaire. The mean age of the participants was 74.0 years. Of the 595 participants, 393 people (66.1%; 67 men and 326 woman) were diagnosed with osteoporosis (T score <−2.5). The prevalence of osteoporosis showed an increasing trend, from 48.1% in 2004 to 66.1% in 2015. Of the 393 participants diagnosed with osteoporosis, 65 participants received additional bone densitometry measurements while hospitalized and osteoporosis management was re-initiated in 44 patients. The osteoporosis management rate in the study cohort increased from 21.6% to 32.8%, with osteoporosis diagnosed in 66.2% of participants at the latest follow-up. This prospective intervention study demonstrated that a screening test and an educational brochure increased the treatment rate from 21.6% to 32.8%.
Cohort Studies ; Densitometry* ; Diagnosis ; Education* ; Follow-Up Studies ; Humans ; Male ; Mass Screening* ; Osteoporosis* ; Pamphlets ; Prevalence* ; Prospective Studies ; Ultrasonography*

PURPOSE: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. MATERIALS AND METHODS: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. RESULTS: The SOS values were observed to be significantly higher in the normal BMD (t score >-1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score <-1). SOS was negatively correlated with age (r=-0.66) and month since menopause (r=-0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. CONCLUSION: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.
Absorptiometry, Photon/*methods ; Aged ; *Bone Density ; Female ; Femur/metabolism/radiography/ultrasonography ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal/diagnosis/metabolism ; Reproducibility of Results ; Sensitivity and Specificity ; Spine/metabolism/radiography/ultrasonography ; Tibia/metabolism/*radiography/*ultrasonography

To identify a proper T-score threshold for the diagnosis of osteoporosis in Koreans using quantitative ultrasonography (QUS), normative data from 240 females and 238 males (ages 20-29 yr) were newly generated. Then, the osteoporosis prevalence estimate for men and women over 50 yr of age was analyzed using previous World Health Organization (WHO) methods and heel QUS. T-scores were calculated from the normative data. There were definite negative correlations between age and all of the QUS parameters, such as speed of sound (SOS), broadband ultrasound attenuation (BUA), and estimated heel bone mineral density (BMD) (p<0.0001). After applying the recently determined prevalence of incident vertebral fracture in Koreans over 50 yr of age (11.6% and 9.1%, female vs male, respectively) to the diagnosis of osteoporosis by T-scores from heel BMD as measured by QUS, it was revealed that applicable T-scores for women and men were -2.25 and -1.85, respectively. These data suggest that simply using a T-score of -2.5, the classical WHO threshold for osteoporosis, underestimates the true prevalence when using peripheral QUS. Further prospective study of the power of QUS in predicting the absolute risk of fracture is needed.
Absorptiometry, Photon ; Adult ; Aged ; Aged, 80 and over ; Bone Density/physiology ; Female ; Fractures, Bone/diagnosis/epidemiology ; Heel/ultrasonography ; Humans ; Korea ; Male ; Middle Aged ; Osteoporosis/diagnosis/*ultrasonography ; Reference Values ; Risk ; Severity of Illness Index ; Young Adult

PADAM is defined by International Society for the Study of the Aging Male(ISSAM) as a biochemical syndrome associated with advancing age and characterized by a deficiency in serum androgen with or without decreased tissue sensitivity to androgen. The precise role of androgens in the aging process of men remains unclear, and there have been few controlled clinical studies in aging men to investigate the effects of androgen replacement therapy on various organs and human functions known to deteriorate with age(except for studies on muscle and bone). These organs and functions include the mind, the cardiovascular system, the immune system, and the composition of body fat. In addition, the effect of androgen replacement therapy on the prostate is very important in terms of its safety in aging men. Good randomized, double-blind, placebo-controlled clinical studies in the aging male are clearly lacking. We need studies that can help us better understand the effect of long-term androgen replacement therapy(both with testosterone and DHEA) on important aspects of men's health: cardiovascular disease, body composition, cognition and dementia, osteoporosis, and the prostate. Until such data will become available(probably not for the next decade), we recommend a careful and individualized evaluation of present health problems combined with assessment of prostatic health(rectal examination, transrectal ultrasound, and PSA measurement), cardiovascular health, and cerebral status(including overall quality of life) be undertaken before androgen replacement is initiated. Treatment should be monitored by the same criteria. The future will probably bring the development of 'designer androgens' with(ideally) beneficial effects on the cardiovascular system, bone, muscle, fat tissues, and brain, and simultaneous neutral or even inhibitory effects on the prostate. The onset of PADAM is unpredictable and its manifestations are subtle and variable, which has led to a paucity of interest in its diagnosis and treatment. Urological practice commonly includes a large proportion of men older than 50 years. Therefore, it is important for urologists to recognize the manifestations of PADAM and be familiar with evaluations necessary to document, monitor, and treat it.
Adipose Tissue ; Aging* ; Androgens ; Body Composition ; Brain ; Cardiovascular Diseases ; Cardiovascular System ; Cognition ; Dementia ; Diagnosis ; Hormone Replacement Therapy* ; Humans ; Immune System ; Male ; Men's Health ; Osteoporosis ; Prostate ; Testosterone ; Ultrasonography

PURPOSE: Metabolic bone diseases have been major problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. METHODS: Forty-four children with renal diseases who were diagnosed at the pediatric nephrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. RESULTS: A total of 44 patients were evaluated. The age at initial diagnosis was 6.7+/-4.2 years. At the time of evaluation, the chronological and bone age was 9.3+/-4.2 years and 8.2+/-4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. CONCLUSION: The prevalence of osteoporosis was 12% in 44 children with renal diseases. No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.
Bone Density ; Bone Diseases, Metabolic ; Child ; Diagnosis ; Equidae* ; Glomerulonephritis, IGA ; Humans ; Nephritis ; Nephrology ; Nephrotic Syndrome ; Osteoporosis ; Precipitating Factors ; Prevalence ; Purpura, Schoenlein-Henoch ; Ultrasonography*

Osteoporosis has been defined as a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. The World Health Organization's standard criterion for the diagnosis of osteoporosis in postmenopausal women and older men is a T-score of ≤-2.5 at the lumbar spine, femur neck, or total hip by bone mineral density measured by dual energy X-ray absorptiometry. To diagnose osteoporosis, quantitative computed tomography, and ultrasound can be used. In this article, we will discuss the methods of diagnosing osteoporosis including imaging techniques and serum turnover markers and the indications of osteoporosis.
Absorptiometry, Photon ; Bone and Bones ; Bone Density ; Diagnosis* ; Female ; Femur Neck ; Global Health ; Hip ; Humans ; Multiple Endocrine Neoplasia Type 1 ; Osteoporosis* ; Spine ; Ultrasonography

OBJECTIVETo study the relationship between ultrasonic bone mineral density (BMD) of calcaneus and age, height, and body weight, and to establish the normal reference value for stiffness index (SI) of healthy subjects in Guangxi autonomous region and provide scientific foundation for the diagnosis and prevention of osteoporosis.

METHODSSI of calcaneus in 1 816 healthy adults aged 11-90 years (775 men, 1 041 women) were measured with quantitative ultrasound. According to their ages, all the men and women were divided into 13 groups by 5-year age group.

RESULTSSI reached peak values in 21-25 year group in men (range: 111.45 +/- 21.19) and in 16-20 year group in women (range: 101.26 +/- 17.51). Then the SI value began to decline with aging. The SI featured by a typical dual-peak curve in women and the decrease rate of SI was faster in women than in men over 61 years. Multivariate linear regression analysis showed significantly negative correlation between SI and age (P < 0.001), positive correlation between SI and body weight (P < 0.05 for men; P < 0.01 for women), and positive correlation between SI and height in women (P < 0.01).

CONCLUSIONSI correlates with age, height, and weight. The acquired SI value may provide a reference for the diagnosis of osteoporosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Density ; Calcaneus ; diagnostic imaging ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; diagnosis ; epidemiology ; Ultrasonography

Osteoporosis is a common metabolic disease which is characteristic of less bone mass and impaired bone microarchitecture, leading to the decreasing of bone strength as well as to the increasing of brittle bones and the risk of fracture. It was found that bone quality, including bone microarchitecture, the composition of mineral and organic matrix, microdamage and the status of bone repair, can influence bone strength as bone mineral density can do. Since the compositions of tissue material are generally similar in people, microarchitecture is used as the important index for the assessment of bone mechanical properties. Currently the none-invasive detective methods in use for bone have become a research topic. Such methods as ultrasonic imaging, computer tomography, magnetic resonance imaging and finite element analysis are reviewed in this paper.
Bone Density ; Bone and Bones ; physiology ; ultrastructure ; Finite Element Analysis ; Humans ; Magnetic Resonance Imaging ; Osteoporosis ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography