What are the ISCD recommendations on quantitative ultrasonography (QUS) in the workup of osteoporosis?

Updated: Jan 20, 2021
  • Author: Rachel Elizabeth Whitaker Elam, MD, MSc; Chief Editor: Herbert S Diamond, MD  more...
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The following are the official positions of the ISCD on QUS [5] :

  • Bone density measurements from QUS devices should be independently validated; measurements by different devices cannot be directly compared

  • The heel is the only validated skeletal site for the clinical use of QUS in osteoporosis management

  • Validated calcaneal QUS devices can be used in postmenopausal women to predict hip, vertebral, and global fracture risk ,and in men older than 65 years to predict hip and all nonvertebral fractures

  • The WHO diagnostic classification cannot be applied to T-scores from QUS measurements

  • If central DXA cannot be obtained, calcaneal QUS in combination with clinical risk factors can be used to identify patients in whom pharmacologic treatment should be initiated

  • Calcaneal QUS plus clinical risk factors can also be used to identify patients at very low fracture probability in whom no further diagnostic testing is necessary

  • QUS cannot be used to monitor the skeletal effects of treatments for osteoporosis

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