Osteoporosis is a common problem in Western societies and is increasing as the population ages. Osteoporosis-related fractures already represent a major problem for the Australian health care budget, and in addition contribute significantly to the demands placed upon the limited resources of the public health system. The cost of management of hip fractures alone, currently exceeds $400 million annually (1). With the projected Australian population over 65 years of age estimated to increase from the current level of 2.25 million, to between 4.02 and 4.05 million by 2021 (2), the increased demand for hospital beds to treat osteoporotic fractures will pose an even larger burden on the health care system in the first quarter of this century. To avoid this impending crisis a number of workers in the field of osteoporosis have suggested a possible approach, based on various screening techniques, to identify high risk individuals, followed by appropriate therapy to reduce fracture incidence (3-5).

There are no clinical features that reliably identify patients with osteoporosis or osteopenia prior to fracture. There is therefore, a need for tools to identify such individuals who could subsequently be investigated further, or in whom preventative measures could be instituted to maintain bone mass. A suitable screening procedure for osteoporosis in the general population should ideally be readily available, reasonably inexpensive and safe. At present the gold standard for measurement of bone mass, and the prediction of fracture risk, is dual energy X-ray absorptiometry (DXA). In recent years however quantitative ultrasound (QUS) of bone has been introduced as a measure of bone mass and due to its portability and freedom from radiation, has been suggested to be a useful screening modality.

Citation
Pocock, N. Quantitative ultrasound in the management of osteoporosis. ASUM Bulletin 2002.1:10-13.