Essay On QUS Of Bone

As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1

Osteoporosis is a disease in which bone tissue is normally mineralized but the mass of bone is decreased and structural integrity of trabecular bone is impaired. Cortical bone becomes more porous and thinner, making bone weaker and prone to fractures. The World Health Organization (WHO)(1994) has defines postmenopausal osteoporosis abased on the bone density. Bone density is based on the number of standard deviations away from the mean bone mineral density of a young adult reference population, a T-score. Normal bone mass density is 0 to -.99 standard deviations, low bone density (osteopenia) is -1.0 to -2.49 standard deviations, osteoporosis is labeled as less than or equal to 2.5 standard deviations, and severe osteoporosis is less than or equal to 2.5 standard deviations and included a bone fracture.

MacNeil & Boyd (2008) investigated the bone strength in elder adults, by carrying out FEA. They then compared the

○ Bone density test to assess for decreased bone density and possible osteoporosis 4, 9

However, this doesn’t mean that fracture risk prediction could be improved by a combined assessment of QUS and bone density. Also, studies on age showed that age-related parameters showed substantial decrease during the period immediately following menopause. [2]

- Differentiated by bone scan with identification of "hot spots" and on plain x-rays by osteo-lytic

As of right now, most researchers diagnose osteopenia by measuring bone mineral density. They do this by using dual energy X-ray absorptiometry of the upper femur and lumbar spine. The World Health Organization requires that to be diagnosed with osteopenia, the bone mineral density has to be between -1 and -2.5. This organization requires that

One factor that had not been investigated was whether the variables of QUS were as affected by clinical risk factors as axial BMD measurements obtained by using the DXA method. A study was conducted to compare the calcaneal QUS and axial BMD T and Z scores in a large group of women (specifically 1115 pre- and postmenopausal women). Some of these women had no clinical risk factors whilst others had one or more risk factors for osteoporosis. (Frost, M. L., Blake, G. M., & Fogelman, I. (2001)). They investigated measurements at the calcaneus using QUS and at the lumbar spine and hip using DXA and found that the variable of QUS were affected to the same extent as axial BMD measurements using the DXA method. This important finding could become critical in the standardisation of QUS in clinical practice.

The strength of the human bone depends on the microstructure contained inside. Every human bone contains osteons, these are aligned in a certain way, osteonal orientation. Usually in humans they are grouped in two antirotary system of opposite direction in the shaft of the bone (diaphysis).There is a general hypothesis that the direction of these osteons is a functional adaptation and depends on the direction of the first stress that acts on the bone. There are a few others who looked into this hypothesis but they considered a sheep tibia. Here the writer of the article is trying to determine the osteonal direction in a human femurs and evaluate the results to see if the above hypothesis was good. In this study the angle of osteonal orientation was measured and also the direction.

All participants underwent calcaneal quantitative ultrasound (QUS) scanning to measure their peripheral BMD. Indeed, QUS method offers an alternative way for bone status evaluation when the limited access to the dual-energy X-ray absorptiometry (DXA) is an issue and the aim is to screen for osteoporosis. Besides, QUS is inexpensive and more portable compared to DXA, while maintaining safety through evading the exposure to the ionizing radiation by DXA (Chin et al., 2013). Moreover, calcaneal QUS and DXA at various anatomic sites were shown to be correlated in several studies, and the measured calcaneal BMD by QUS was efficient and analogous to the measured hip BMD using DXA in hip fracture prediction (Moayyeri et al., 2012; Chin et al., 2013). To ensure that the QUS device was generating accurate measures, daily calibration of the device was performed by means of a phantom provided by the manufacturer. The device uses the ultrasound pulse penetration technique that computes the speed of sound (Baroncelli, 2008). Subsequently, the T-score are instantly derived. The T-score, which is used to describe the BMD, is defined as the number of standard deviations above or below the mean BMD of a

These measurements may vary from scientist to scientist and from observation to observation. The manual measurements may lead to errors also time consuming processes. There is no standard clinical procedure in bone age assessment, even if the most used methods are: 1) The Greulich and Pyle (G&P) method [10]. 2) The Tanner and Whitehouse method [12]. Both methods rely on X-Ray images.

Finite element analysis uses computer models of images and data from QCT of the spine or hip to assess bone strength. (76) It is also comparable to hip DEXA in predicting hip

Aging tends to take a toll on our bone health. However, with proper care and attention, bone health can be improved, lowering the risk of painful and debilitating conditions, including osteoporosis and compression fractures. ​

A large number of studies in the last decades, have confirmed the usefulness of QUS to predicte osteo¬porotic fractures of the calcaneus (particularly in elderly women aged 65-70 years or older), the distal metaphysis of the phalanx, the radius and the tibia (50).

field of dento-maxilla facial radiology is gaining importance and becoming widespread (98). Although the clinical relevance of dental diagnosis and pre-surgical assessment of jaw bone density has been clearly demonstrated, the available research on CBCT-based bone quality is scant (99). A new tool, the computed tomography index, was proposed to assess the BMD on CBCT images ;( 100) with it, CBCT images can be used to evaluate women with osteoporosis, thus increasing the possibilities for screening and early detection. A recent study evaluated the mandibular index on