New Ultrasound-Based Methods for Early Osteoporosis Diagnosis and Fracture Risk Estimation

New Ultrasound-Based Methods for Early Osteoporosis Diagnosis and Fracture Risk Estimation

Sergio Casciaro (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Maria Daniela Renna (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Paola Pisani (National Research Council, Institute of Clinical Physiology, Lecce, Italy), Antonio Greco (Echolight S.r.l., Lecce, Italy), Francesco Conversano (National Research Council, Institute of Clinical Physiology, Lecce, Italy) and Maurizio Muratore (O.U. of Rheumatology, “Galateo” Hospital, San Cesario di Lecce, ASL-LE, Lecce, Italy)
DOI: 10.4018/IJMTIE.2014040103

Abstract

Osteoporosis is the most common disorder of bone metabolism. The main consequence of this disease is the increased risk of fracture. Osteoporotic fractures represent a serious problem in terms of social and economic costs. Then, there is a strong need for the assessment of the best practices in prevention and treatment of osteoporosis. Dual X-ray absorptiometry (DXA) represents the current “gold standard” method for osteoporosis diagnosis. However, DXA cannot be employed for population mass screenings, because of required exposition to ionizing radiation and high management costs. The aim of this paper was to review the currently available techniques for osteoporosis diagnosis and also to illustrate the feasibility of an innovative quick, cheap and non-invasive ultrasound-based methodology. The results recently published by the authors' research group suggest that the proposed approach has the potential for routine application in early diagnosis, which is the key to resize the impact of osteoporosis on healthcare systems.
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Epidemiology In Italy And In The World

Osteoporosis has a significant impact on public health through the increased rates of morbidity, mortality and economic costs associated with bone fractures. The frequency of osteoporotic fractures is in fact rising in many countries. In 1990, there were an estimated 1.7 million hip fractures worldwide (Cooper et al., 1992) and by 2050 they could exceed 21 million (Cummings and Melton, 2002; Johnell and Kanis, 2006). This is in particular due to the increased longevity of the population and the consequently higher prevalence of chronic diseases, including osteoporosis and the complications due to related fragility fractures.

In Italy, since 1950, life expectancy at birth has increased by 4 months per year and, currently, is 77.9 years for men and 84.4 years for women (Istat, 2013). People over 65 years of age represent more than 20% of Italian population, and this demographic trend is also increasing. Then, one in five women and one in seven men are over 65 years of age. Among these, octogenarians are 5% and will exceed 11% in 2045 (Istat, 2013). Nowadays, in our country there are 137.7 people aged over 65 for every 100 young people under 15 years of age, with some differences between the North (157.9), Center (160.7) and South (106.6) (Istat, 2013).

The epidemiological study ESOPO (Epidemiological Study On the Prevalence of Osteoporosis), carried out in 2000 in Italy on 16,000 patients recruited in 83 centers with the collaboration of 1,850 family physicians, showed that osteoporosis is a disease with a high prevalence in Italy, especially among women (Adami et al., 2003; Maggi et al., 2006): there are around 4 million of women exposed to an increased fracture risk (in particular women aged over 75 years), and more than 800,000 men.

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