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IP International Journal of Orthopaedic Rheumatology


USOFRA study using QUS Ultrasound of the heel bone to detect osteoporosis demonstrating height loss as a vital risk factor in women


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Author Details: AP Singh, Dipali Das, Vandana Singh, Neha Bisht, Ritu Mehta, Chitra Kapoor

Volume : 2

Issue : 1

Online ISSN : 2581-9151

Print ISSN : 2581-8112

Article First Page : 1

Article End Page : 8


Abstract

Background: Osteoporosis, is a silent progressive disease associated with low bone density and resultant deterioration of bone micro architecture and fragility fractures.
Unfortunately, the Dexa-Scan is not widely available, it is expensive and involves exposure to some amount of radiation.
India is a developing country with limited health resources and economic restrictions. Evolving cost- effective methods to detect osteoporosis with possibilities of widespread usage are desirable.
Material & Methods: Detailed clinical data, height, weight and T- score measurements from QUS heel studies of 1843 patients (including 1225 females & 518 male) were obtained from the USOFRA (Uma Sanjeevani Osteoporosis screening and Fracture Risk Assessment) study from 2008 till date.
Observations: The study demonstrates an increasing incidence of severe height loss with advancing age & correspondingly higher incidence of fragility fractures.
403 Women with Mild Height Loss (<1”) having no Fragility fractures had high T- scores.
105 Women with Severe Height Loss (>1”) with Fragility fractures had the low T-scores especially in the younger women aged 40 – 60.
The heavier women aged 40 – 60 years, who suffered mild height loss, had much stronger bones evident by their highest T-scores, than the women who were light and had severe height loss, who had the lowest T-scores.
Discussion: It was found that additional clinical risk factor ‘Severe Height Loss (>1), which when coupled with low body weight <65 kg, and QUS heel T-score< -1.0’ showed greater risk of fragility fractures.
Conclusions: The study demonstrated that Height Loss more than 1” and low body weight are significant risk factors which together with a low T-score, help in the detection of osteoporosis.
Severe Height Loss (>1”) obtained by deducting present height measurement from self-reported height known from youth (age 20-25), is a valuable clinical risk factor for osteoporosis. It can be used in women aged 40 years and above as a screening tool for early detection of osteoporosis.

Keywords:
Post-menopausal Osteoporosis; Osteopenia; QUS Heel; T-score; BMD; Height Loss; Clinical Risk Factors; Fragility Fracture