Osteosonography (synonym: quantitative ultrasonography; QUS) is a diagnostic procedure for measuring and evaluating bone density, particularly in patients at risk for osteoporosis. The method is also used for early diagnosis and monitoring of osteoporosis (bone loss). The method belongs to the procedures of osteodensitometry (bone density measurement). One of these is the Lunar Achilles Insight device, which uses sonography (ultrasound) for precise measurement of bone density and thus contributes to the diagnosis and early detection of diseases of the skeletal system. Measuring bone density at the calcaneus has proven to be particularly useful, as the measurement results allow conclusions to be drawn about the condition of the rest of the skeletal system. The age-related loss of bone density or bone mass is a natural physiological process. Bone mass reaches its maximum by the age of 30; this value is also referred to as “peak bone mass”. Osteodensitometry is used to distinguish physiological bone loss from osteopenia (reduction in bone density) or osteoporosis (reduction in bone mass with increased susceptibility to fracture). Only a bone mass loss of 30% is visible in the native X-ray (increased radiolucency), but even a 10% loss leads to a threefold risk of femoral neck fracture and twice the risk of fracture (bone fracture risk) in the trunk spine. Thus, the decrease in bone density correlates with fracture risk. Measurement by osteosonography using the lunar method on the calcaneus can provide a good estimate of the risk of future femoral neck fracture.
Indications (areas of application)
- Osteoporosis:
- Early detection of osteoporosis (bone loss).
- Early detection of osteopenia (reduction in bone density).
- Fracture risk assessment (bone fracture risk assessment).
- Stage classification of manifest osteoporosis.
- Follow-up of the progression
- Follow-up of the (drug) therapy.
- Patients over 65 years of age without risk factors for bone density reduction.
- Patients over 65 years of age with the following risk factors:
- Family history of osteoporosis – at least two family members with osteoporosis.
- Family history of diseases associated with bone density reduction.
- Hypogonadism – gonadal insufficiency (testes/ovaries) of male and female, respectively.
- Early climacteric (menopause, menopause)
- Fracture (bone fracture) after menopause.
- Age-related, significant loss of body size.
- Consumption of stimulants: alcohol (woman: > 20 g/day; man: > 30 g/day); tobacco (smoking – in osteoporosis after menopause).
- Lack of exercise
- BMI (body mass index) < 20 kg/m²
- Unintentional weight loss of more than 10 kg or of more than 10% in the last few years
- No estrogen substitution in the postmenopausal period.
- Other indications:
- Hormonal factors – estrogen deficiency in girls and young women, e.g., late menarche (delayed puberty, > 15 years of age).
- Early onset of menopause (< 45 years of age) or early ovariectomy (removal of the ovaries).
- Menopause (menopause in women)
- Andropause (menopause of the male)
- Anorexia nervosa (anorexia)
- Chronic diseases or surgeries that can trigger bone loss, e.g., small intestine diseases and stomach surgery
- Chronic renal insufficiency (chronic renal failure).
- Increased risk of falls (more than 2 falls in 6 months).
- Previously occurred fractures (bone fractures)
- Joint diseases with restricted movement
- Hyperthyroidism (hyperthyroidism)
- Hyperparathyroidism (parathyroid hyperfunction).
- Osteopathies (bone diseases)
- Glucocorticoid long-term therapy – cortisol intake.
- Systemic long-term therapy with the following other drugs: Antiepileptic drugs, glucocorticoids, heparin, Marcumar.
- Therapy with immunosuppressants after organ transplantation.
- Patients after transplantation, especially of kidney, liver and heart.
- Condition after surgery in the gastrointestinal tract (gastrointestinal tract).
The procedure
Osteosonography using the Lunar method is a non-invasive procedure. The modern equipment technology does not expose the patient to any stress. The patient is in a comfortable seated position while his or her calcaneus ergonomically inserts into the device. The Lunar Achilles Insight device is easy to operate and fits perfectly into the daily use of a practice due to its compactness and light weight (10 kg). The technical principle is based on quantitative ultrasound measurement. The specific sound conduction velocity and the sound attenuation through the bone are measured, which allow an assessment of the density of the bone tissue. The preferred measurement site, in addition to the splint bone, forearm or finger, is the heel bone, as is also the case with the lunar method. On one side of the heel bone there is a transmitter that sends ultrasound waves through the heel bone. These are registered and logged by a receiver on the opposite side of the heel bone. The device measures both the time it takes for the ultrasound waves to travel from the transmitter to the receiver and how much ultrasound is absorbed by the bone. This is then used to calculate the sound conduction velocity and the sound attenuation.
Benefit
Osteosonography using the Lunar method is a powerful diagnostic procedure for assessing bone density and bone composition of the entire skeletal system. The most important field of application is the diagnosis, staging and follow-up of osteoporosis with regard to fracture risk. Regular check-ups will significantly reduce your risk of fracture and improve your quality of life.
