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Utility of Quantitative Ultrasound of the Calcaneus in Diagnosing Osteoporosis in Spinal Cord Injury Patients

Bittar, Cíntia Kelly MD; Cliquet, Alberto Jr PhD; dos Santos Flöter, Michelle AMS

American Journal of Physical Medicine & Rehabilitation: June 2011 - Volume 90 - Issue 6 - p 477-481
doi: 10.1097/PHM.0b013e31821a7386
Original Research Articles: SCI

Objective: The aim of this study was to assess the utility of quantitative ultrasound of the calcaneus in diagnosing osteoporosis in spinal cord injury patients in a Brazilian Teaching Hospital.

Design: This is a diagnostic test criterion standard comparison study. Between January 2008 and October 2009, the bone density of 15 spinal cord injury patients was assessed for analysis before beginning rehabilitation using muscle stimulation. The bone density was assessed using bone densitometry examination (DEXA) and ultrasound examination of the calcaneus (QUS). The measurements acquired using QUS and DEXA were compared between patients with spinal cord injury and a control group of ten healthy individuals.

Results: The T-score values for femoral neck using DEXA (P < 0.0022) and those using QUS of the calcaneus (P < 0.0005) differed significantly between the groups, and the means in the normal subjects were higher than those in spinal cord injury patients who would receive electrical stimulation. In spinal cord injury patients, the significant differences were found between the QUS T-score for calcaneus and the DEXA scores for the lumbar spine and femoral neck.

Conclusions: Because of the low level of mechanical stress on the calcaneus, the results of the QUS could not be correlated with the DEXA results for diagnosing osteoporosis. Therefore, QUS seems to be not a good choice for diagnosis and follow-up.

From the Orthopaedics Department, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil (CKB, AC); Orthopaedics Department, Faculty of Medical Sciences, Catholic University of Campinas (PUC), Campinas, Brazil (CKB, MdSF); and Electrical Engineering Department, University of São Paulo (USP), São Carlos, Brazil (AC).

All correspondence and requests for reprints should be addressed to: Cíntia Kelly Bittar, MD, Rua Santo Irineu, n 285, Apartment 44, Bairro Saúde, CEP 04127-120, São Paulo, Brazil.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.