Did you ever stick your foot in a tool that measured your bone density on the heel? In that case, this was an ultrasound gadget that tried to detect bone density and bone energy by sending soundwaves via the bone. I’ve been watching the evolution of ultrasound testing over the a long time and have seen a number of analysis articles  suggesting that bone ultrasound testing would possibly effectively have the ability to uncover the strength-determining qualities of bone along with bone density.

For instance, in 1998 European researchers advised that quantitative ultrasound (QUS) represented a promising method for the prognosis of osteoporosis and that this radiation-free expertise offered data not solely on bone density but additionally on bone high quality and bone energy. (1)

The brand new modern-day ultrasound bone density take a look at

Now 20 years later Italian scientists have developed a contemporary ultrasound gadget that’s able to measuring bone on the hip and the backbone. In depth testing achieved between 2013 and 2016 means that this new Radiofrequency Echographic Multi Spectrometry (REMS) gadget could also be an efficient radiation-free solution to assess bone density and, much more, to judge bone energy and fracture danger. The ultrasound gadget generally known as Echolight was not too long ago authorised by the FDA and medical doctors within the US are starting to provide it a strive.

A number of days in the past my consumer Valerie reported that she was given a free take a look at drive of this new ultrasound gadget. She was provided a free Echolight take a look at whereas attending an train program, and despite the fact that simply 3 days earlier than she had had her common DEXA bone density take a look at, she accepted the provide. The gadget is radiation-free, and the take a look at is fast and straightforward, so she was recreation for a strive. Because it turned out, nevertheless, the 2 bone density measuring units delivered fairly completely different outcomes. The brand new ultrasound gadget reported considerably decrease readings than the DEXA.

This disparity in take a look at outcomes impressed me to dig a bit deeper into the Echolight (REMS) analysis. Taking a look at their printed articles and speaking to people educated on this new expertise confirmed my suspicion that there was an issue right here. (2, 3, 4)

We’ve recognized for a very long time that many errors can happen utilizing the usual DEXA bone density testing machines. For instance, the DEXA is operator dependent and placement on the gadget is a vital variable. Complete articles have been written on frequent errors incurred with DEXA testing (5). Much more essential to me is the truth that bone density testing by DEXA doesn’t precisely predict fracture danger, in that the overwhelming majority of people that fracture would not have an “osteoporotic bone density” by DEXA. (6)

So which bone density take a look at was extra correct in Valerie’s case? And can REMS substitute DEXA?

My solutions to those questions are a piece in progress. I regarded on the analysis and contacted Dr. Kimberly Zambito, an orthopedic surgeon who was not too long ago educated in Echolight testing. Having achieved 25+ Echolight REMS scans to this point, Dr. Zambito discovered the brand new Echolight scan stories to be in step with DEXA when it comes to bone mineral density, apart from these sufferers who had poor high quality DEXA scans. I suppose time will inform if cautious researchers will give you the identical outcomes. (7)

Whereas it’s nonetheless not clear how this can end up in Valerie’s case, or if the brand new ultrasound will substitute DEXA, I wished to share this new expertise with you. I’ve an intuitive feeling that ultrasound has the potential to offer a safer and much more correct solution to assess bone density, and maybe it’d even inform us a bit extra about bone energy and fracture danger.

If you’re provided an Echolight take a look at, and it occurs to be across the similar time as your DEXA bone density take a look at, strive it out. I’d like to see the outcomes. And I will probably be following this analysis and will seemingly interview just a few of the important thing scientists and physicians utilizing this expertise.

Keep sturdy, and keep tuned in.

References:

1. Prins, S. H., et al. 1998. The function of quantitative ultrasound within the evaluation of bone: A overview. Scientific Physiology (Oxford, England) 18(1):3-17.
2. Di Paola, M., et al. 2019. Radiofrequency echographic multispectrometry in contrast with twin X-ray absorptiometry for osteoporosis prognosis on lumbar backbone and femoral neck. Osteoporosis Worldwide 30:391-402.
3. Adami, G., et al. 2020. Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up examine. Bone 134:115297.
4. Cortet, B., et al. 2021. Radiofrequency echographic multi spectrometry (REMS) for the prognosis of osteoporosis in a European multicenter scientific context. Bone 143:115786.
5. Kaleta, M., and S. Wroń 2001. The commonest errors within the densitometric prognosis of osteoporosis. Ortopedia, Traumatologia, Rehabilitacja 3(3):338-344.
6. Brown, S. E. 2015. How can we inform who will fracture? Past bone mineral density to the brand new world of fracture danger evaluation. Higher Bones web site, accessed April 21, 2021.
7. Dea Tomai Pitinca, M., et al. 2021. May radiofrequency echographic multi-spectrometry (REMS) overcome the constraints of BMD by DXA associated to artifacts? A collection of three circumstances. Journal of Ultrasound in Medication. DOI: 10.1002/jum.15665 printed on-line 21 February 2021.