Journal of Ultrasound in Medicine, Vol 19, Issue 4 251-256, Copyright © 2000 by American Institute of Ultrasound in Medicine
Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study
G. Luisetto, V. Camozzi and F. De Terlizzi
Department of Medical and Surgical Sciences, Institute of Semeiotica Medica, University of Padua, Italy.
The aim of this work was to use ultrasonographic technology to
differentiate osteoporosis from osteomalacia on the basis of different
patterns of the graphic trace. Three patients with osteomalacia and three
with osteoporosis, all with the same lumbar spine bone mineral density,
were studied. The velocity of the ultrasound beam in bone was measured by a
DBM Sonic 1,200/I densitometer at the proximal phalanges of the hands in
all the patients. The ultrasound beam velocity was measured when the first
peak of the waveform reached a predetermined minimum amplitude value
(amplitude-dependent speed of sound) as well as at the lowest point prior
to the first and second peaks, before they reached the predetermined
minimum amplitude value (first and second minimum speeds of sound). The
graphic traces were further analyzed by Fourier analysis, and both the main
frequency (f0) and the width of the peak centered in the f0 (full width at
half maximum) were measured. The first and second minimum speeds of sound
were significantly lower in the patients with osteomalacia than in the
osteoporosis group. The first minimum speed of sound was 2,169 +/- 73 m/s
in osteoporosis and 1,983 +/- 61 m/s in osteomalacia (P < 0.0001); the
second minimum peak speed of sound was 1,895 +/-59 m/s in osteoporosis and
1,748 +/- 38 m/s in osteomalacia (P < 0.0001). The f0 was similar in the
two groups (osteoporosis, 0.85 +/- 0.14 MHz; osteomalacia, 0.9 +/- 0.22
MHz; P = 0.72), and the full width at half maximum was significantly higher
in the osteomalacia patients (0.52 +/- 0.14 MHz) than in the osteoporosis
patients (0.37 +/- 0.15 MHz) (P = 0.022). This study confirms that
ultrasonography is a promising, noninvasive method that could be used to
differentiate osteoporosis from osteomalacia, but further studies should be
carried out before this method can be introduced into clinical practice.
