Bone Abstracts

Objective: According to National Osteoporosis Foundation (NOF) guidelines, treatment is recommended for osteoporotic patients and patients with osteopenia and high fracture probability (FRAX with BMD over 3% for hip and/or over 20% for other fractures). In this study, a pocket size pulse-echo (PE) ultrasound (US) device and FRAX with BMI is used in treatment pathway analysis and compared to NOF guidelines.

Materials and methods: Elderly Caucasian woman (n=427, age=69±9 years) were examined using Bindex device. Bindex reports a diagnostic parameter, density index, DI. Previously, the 90% sensitivity and specificity thresholds for DI were determined along ISCD guidelines in diagnostics of osteoporosis. By using these thresholds, subjects were classified as healthy (green), osteoporotic (red) or in need of DXA examination to verify diagnosis (yellow). Osteoporosis was assessed by proximal femur axial DXA. In addition, FRAX scores with BMD (FRAX_BMD) and with BMI (FRAX_BMI) were determined.

Results: A total of 173 subjects (73 osteoporotic) were selected to be treated along NOF guidelines. FRAX_BMI was analyzed for patients with DI value in yellow or green area. Subjects with red DI value and yellow DI value with FRAX_BMI over 20% were selected to be treated. Subjects with yellow DI value and FRAX_BMI under 20% or green DI value and FRAX_BMI over 20% were selected for additional DXA measurement. The patients with green DI value and FRAX under 20% were considered healthy. The sensitivity and specificity of treatment decisions were 84 and 93%, respectively. Only 31% of the patients were found to require additional DXA measurement to verify the treatment decision.

Conclusion: The present results demonstrate that the ultra-portable US instrument with FRAX_BMI shows strong agreement (89%) with treatment decisions using NOF guidelines.