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Comparison of calcaneal ultrasound and DXA to assess the risk of corticosteroid-induced osteoporosis: a cross-sectional study

Comparison of calcaneal ultrasound and DXA to assess the risk of corticosteroid-induced osteoporosis: a cross-sectional study
Comparison of calcaneal ultrasound and DXA to assess the risk of corticosteroid-induced osteoporosis: a cross-sectional study
Patients on long-term oral corticosteroids have an increased risk of low bone mass and fragility fractures. Fracture risk rises soon after commencement of corticosteroid therapy and it is possible that these agents adversely influence bone architecture disproportionately to their effect on bone mass. The best means of assessing bone status in patients using corticosteroids remains uncertain, but quantitative ultrasound of the calcaneus may provide evidence of microarchitectural changes not detected by dual-energy X-ray absorptiometry (DXA). Patients with Crohn's disease have an increased risk of low bone mineral density (BMD), the etiology of which is multifactorial but includes corticosteroid use. We studied 118 consecutive patients with Crohn's disease, 21 of whom used continuous oral corticosteroids, 70 of whom were intermittent users, and 27 who had never used the drug. All patients received DXA of the lumbar spine, hip and calcaneus and quantitative ultrasound (QUS) of the calcaneus. The different techniques were compared using a femoral neck T-score hm1.5 as the threshold of corticosteroid-induced osteoporosis. When compared with the femoral neck T-score, there were no significant differences between the predictive values of lumbar spine DXA, calcaneal DXA or calcaneal QUS to identify low femoral neck BMD. However, the absolute T-score required to give similar discriminatory capacity to femoral neck T-score varied substantially (T = m0.81 to m1.5) between the different measurement techniques and sites.
calcaneal dxa, calcaneal us, crohn's disease, inflammatory bowel disease, osteoporosis
0937-941X
788-793
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
McCrudden, P.R.
e6839e7b-e28c-4c31-b5e6-273c3352d5ae
Taylor, P.
28b91e71-fad2-4375-8a1e-535f861901c3
Petley, G.W.
4f2da40b-3c7b-4adc-b75c-e24e62bb1cf0
Stroud, M.
1665ae65-0898-4848-bf0d-baec8f2bb078
Fine, D.R.
ce3d6a77-040e-4aec-a8f5-4c4c22431605
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
McCrudden, P.R.
e6839e7b-e28c-4c31-b5e6-273c3352d5ae
Taylor, P.
28b91e71-fad2-4375-8a1e-535f861901c3
Petley, G.W.
4f2da40b-3c7b-4adc-b75c-e24e62bb1cf0
Stroud, M.
1665ae65-0898-4848-bf0d-baec8f2bb078
Fine, D.R.
ce3d6a77-040e-4aec-a8f5-4c4c22431605
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f

Javaid, M.K., McCrudden, P.R., Taylor, P., Petley, G.W., Stroud, M., Fine, D.R., Cooper, C. and Arden, N.K. (2001) Comparison of calcaneal ultrasound and DXA to assess the risk of corticosteroid-induced osteoporosis: a cross-sectional study. Osteoporosis International, 12 (9), 788-793. (doi:10.1007/s001980170056). (PMID:11605746)

Record type: Article

Abstract

Patients on long-term oral corticosteroids have an increased risk of low bone mass and fragility fractures. Fracture risk rises soon after commencement of corticosteroid therapy and it is possible that these agents adversely influence bone architecture disproportionately to their effect on bone mass. The best means of assessing bone status in patients using corticosteroids remains uncertain, but quantitative ultrasound of the calcaneus may provide evidence of microarchitectural changes not detected by dual-energy X-ray absorptiometry (DXA). Patients with Crohn's disease have an increased risk of low bone mineral density (BMD), the etiology of which is multifactorial but includes corticosteroid use. We studied 118 consecutive patients with Crohn's disease, 21 of whom used continuous oral corticosteroids, 70 of whom were intermittent users, and 27 who had never used the drug. All patients received DXA of the lumbar spine, hip and calcaneus and quantitative ultrasound (QUS) of the calcaneus. The different techniques were compared using a femoral neck T-score hm1.5 as the threshold of corticosteroid-induced osteoporosis. When compared with the femoral neck T-score, there were no significant differences between the predictive values of lumbar spine DXA, calcaneal DXA or calcaneal QUS to identify low femoral neck BMD. However, the absolute T-score required to give similar discriminatory capacity to femoral neck T-score varied substantially (T = m0.81 to m1.5) between the different measurement techniques and sites.

Full text not available from this repository.

More information

Published date: 2001
Keywords: calcaneal dxa, calcaneal us, crohn's disease, inflammatory bowel disease, osteoporosis
Organisations: Human Development & Health, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 383382
URI: https://eprints.soton.ac.uk/id/eprint/383382
ISSN: 0937-941X
PURE UUID: ea3a9e56-22c8-43b2-8589-48bc4182bbc9
ORCID for G.W. Petley: ORCID iD orcid.org/0000-0002-3295-0444
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 29 Jan 2016 11:23
Last modified: 06 Jun 2018 13:01

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