Weak-heel test may ID best candidates for osteoporosis screens

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Low bone strength of the heel as measured by a portable and relatively inexpensive ultrasound test could help pinpoint women who need more costly bone mineral density (BMD) screening.

“Because the incidence of osteoporosis is expected to outpace economic resources, it is crucial to develop improved detection methods that can identify those women who need dual x-ray absorptiometry measurement and will potentially benefit from treatment,” note the authors (Radiology. 2008;248:179-184).

Researchers followed 6,174 women aged 70-85 years who were osteoporosis-free at baseline. Quantitative ultrasound (QUS) was used to assess heel BMD and calculate the bone's stiffness index (a measure of bone strength). These results were evaluated in conjunction with four clinical risk factors for osteoporosis: age older than 75 years, a history of fracture, a recent fall, and failing a chair test (unable to rise from a chair three times in a row without using one's arms).

A total of 4,710 women (76.3%) were deemed to be at higher risk of osteoporosis. Over the next 2.8 years, 6.1% (290 members) of the higher-risk group suffered osteoporotic fractures, compared with only 1.8% (27 members) of the lower-risk group.

The study found that a low QUS score (<60%) quadrupled the osteoporotic fracture rate, confirming previous findings that this measurement is a useful independent predictor of such risk.

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