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New Test for Osteoporosis Fracture Risk

Heel Ultrasound Could Be Alternative to X-Ray Bone Density Testing for Some Patients

Heel Ultrasound Predicts Risk continued...

Different versions of the "chair-stand test" are widely used to measure lower body strength and falling risk in frail and elderly populations.

Using this five-item model, the researchers concluded that 1,464 of the women (24%) were at lower risk for fractures and 4,710 (76%) had a higher risk.

The women were then followed for three years, during which time 66 women had a hip fracture. Nine out of 10 fractures occurred among women in the higher-risk group.

The study appears in the July issue of Radiology.

"Fracture risk is not just related to the strength of your bones," says Guessous. "It is also determined by risk of falling, but this risk is often overlooked by clinicians."

He adds that the heel ultrasound combined with risk assessment could prove useful for identifying lower-risk people who may not need further bone density testing.

Heel Ultrasound vs. Bone Density X-Ray Testing

Thomas Jefferson University Hospital radiology professor Levon Nazarian, MD, tells WebMD that heel ultrasound may represent a safer alternative to bone density X-ray testing for some patients.

"Anytime you can avoid radiation, that is a good thing," he says. "If it turns out that [ultrasound] screening keeps some patients from needing more testing, it could be beneficial."

But National Osteoporosis Foundation Clinical Director Felicia Cosman, MD, sees little need for the ultrasound screening, especially in the U.S.

She says X-ray-based bone density testing remains the single best predictor of risk of hip fracture.

"[X-ray] bone density testing is accessible to just about everyone, except perhaps those living in really rural, remote areas," she says. "And it is widely covered, so cost is not a big issue. In this country, at least, it is difficult to make the argument that people should have other tests."

Cosman says the utilization of bone density testing is high among many at-risk groups in the U.S., but she adds that this is unfortunately not true for those with the highest risk -- elderly people who have had previous hip or spine fractures.

"Many of these patients get treated for their fracture with no follow-up in terms of testing or treatment for osteoporosis," she says. "These are the patients you want to make sure you evaluate and treat."

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