ABSTRACT:
Osteoporosis is a disease that is characterized by low bone mass, deterioration of bone tissue, and disrup¬tion of bone microarchitecture. The diagnosis and clinical management of osteoporosis relies mainly on the measurement of bone density, because low bone density is associated with future risk of atraumatic and fragility fractures. During the last three decades several techniques have been developed for the measurement of bone density which are safe, precise, and accurate. Most of these techniques used some form of ionizing radiation (x-rays), and the measurement obtained is based on the attenuation of a beam of energy as it passes through bone and soft tissues. The use of acoustic energy in the form of ultrasound wave has been suggested as possible choice for the assessment of bone integrity and to determine bone's response to mechanical loads to predict the risk of fracture. Transmission mode uses two transducers, one acting as transmitter and the other as a receiver of the ultrasound wave. Achilles Express bone Ultrasonometer is used to evaluate bone status by measuring stiffness index in the heel. Measurement of BUA (Broadband Ultrasound Attenuation) involves sending a broadband ultrasound pulse through the bone and measuring the reduction in intensity at different frequencies. Stiffness Index which represents bone mineral density, combines BUA and SOS (Speed of Sound) into a single clinical measure that has a lower precision error than either variable alone. The T-score is the most significant parameter for the assessment of osteoporosis. It is concluded that QUS can be effectively used to study the bone mineral loss and QUS clearly distinguishes between normal and osteoporotic subjects and can be a useful index in clinical management of osteoporosis. Thus Achilles Express Ultrasonometer is a reasonable and accurate screening tool to detect low BMD.