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Quantitative US of the Calcaneus: Cutoff Levels for the Distinction of Healthy and Osteoporotic Individuals¹

¹ From the Department of Osteology, Universitätsklinik für Radiodiagnostik, Währinger Gürtel 18-20, 1090 Vienna, Austria (S.G., C.H., C.K., F.K., S.Y., F.V., H.I.); Department of Radiology, University of California, San Francisco (S.G., Y.L.); and Department of Internal Medicine, Krankenhaus der Barmherzigen Schwestern, Vienna, Austria (H.R.). From the 1999 RSNA scientific assembly. Received August 15, 2000; revision requested October 11; revision received January 24, 2001; accepted March 7. Supported by the Ludwig-Boltzmann Institut für Klinische und Experimentelle Radiologie and Ludwig-Boltzmann Institut für Fortgeschrittene Altersforschung, Vienna, Austria. Address correspondence to S.G. (e-mail: stephan.grampp@univie.ac.at).

PURPOSE: To calculate cutoff levels for quantitative ultrasonography (US) performed to distinguish healthy individuals and those with osteoporosis identified with dual x-ray absorptiometry.

MATERIALS AND METHODS: In 1,357 patients (856 females, aged 55.1 years ± 15.4 [mean ± SD]; 501 males, aged 50.4 years ± 15), bone mineral density measurements of the lumbar spine (posteroanterior, L1 through L4) and femoral neck were obtained, and quantitative US was performed to determine the stiffness of the calcaneus. Individuals with a T score less than -2.5 (osteoporotic) at the spine and femur were identified, and upper T-score cutoff values (3 SDs from the mean) in the groups of male and female patients with osteoporosis were identified.

RESULTS: Females with dual x-ray absorptiometric values that were indicative of osteoporosis of the spine had an upper T-score cutoff value of -1.0 (males, -0.2). Females who had femoral osteoporosis showed an upper quantitative US T-score cutoff value of -0.6 (males, 0).

CONCLUSION: Cutoff values may permit the use of quantitative US to screen for the presence of osteoporosis in the spine and femur. Quantitative US will help to prevent unnecessary dual x-ray absorptiometric and conventional radiographic examinations.

Index terms: Bones, mineralization, 331.1295, 443.1295, 4642.12989 • Bones, US, 331.1298, 43.1298, 4642.1298 • Osteoporosis, 331.56, 443.56, 4642.56

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