Norm of Bone Ultrasonometry
The lower the T-score, the greater the risk for fracture.
T-score ≤1.0 = low bone mass, at increased risk for fracture.
Usage of Bone Ultrasonometry
This test is used to determine a qualitative ultrasound measurement of the calcaneus. This along with clinical factors is used to assist in determining osteoporosis, primary hyperparathyroidism, risk for fracture, and type 1 Gaucher's disease.
Description of Bone Ultrasonometry
This procedure uses an ultrasonometer to measure bone density of the heel and identify bone fragility and risk for osteoporosis. The ultrasonometer is an ultrasound device that measures the speed of sound and broadband ultrasonic attenuation of an ultrasound beam passed through the heel. The process determines a quantitative ultrasound index (QUI), expressed as a T-score and an estimate of the bone mineral density (BMD in g/cm2) of the heel. Ultrasonographic bone densitometry of the heel is most useful as a screening tool. It is not recommended for frequent monitoring of response to osteoporosis treatment because the heel does not respond quickly to treatment. A 3-year interval is recommended by the manufacturer as necessary to identify improvement. Other methods of bone density testing should be used if more frequent monitoring is needed. (The test described below is based on information available for the Sahara Clinical Bone Sonometer. At least 15 commercial systems are available.)
Professional Considerations of Bone Ultrasonometry
Consent form NOT required.
The Sahara should not be used in clients whose skin is abraded or have an open sore in an area that comes in contact with the system.
- The client must remove shoes and socks or stockings.
- If the test has been performed in the past, select the same foot for testing.
- The client's heel is covered with Sahara Coupling Gel and then rested against the ultrasonometer.
- Remove gel from heel.
Client and Family Teaching
- The test takes only a few seconds, and results are available during the same visit.
- No x-rays or radiation is involved.
- T-Score -2.5 to -4.0:
- a. Treatment is usually indicated in this range.
- b. Treatment is almost always indicated if there has been an osteoporotic fracture.
- T-Score -0.5 to -2.5
Treatment may be indicated in this range if:
- a. There is a family history of osteoporosis.
- b. There is a history of smoking.
- c. The client is underweight or has experienced a weight loss.
- d. The range is close to a -2.5 T-score.
- e. There is a likelihood of bone loss.
- T-Score +1.0 and above:
- a. Values in this range are good. Continue to maintain a healthy lifestyle, exercise, and eat a good diet.
- With extra risk factors consider a baseline DEXA scan.
Factors That Affect Results
- Sahara Coupling Gel should be used as directed, and no other gels should be substituted because water-based gels have been associated with coupling delays.
- Avoid measuring bone density on a foot or limb that has had a recent reduction because of immobilization or fracture, for example.
- Although ultrasound bone sonometry allows one to predict the risk of hip fracture in elderly females almost as well as dual-energy x-ray absorptiometry (DEXA), the latter is considered the standard of comparison often used for measuring bone density.
- Testing can be done in a physician's office. Medicare reimbursement is not available for this test because of its designation as a screening test.