La densitometria con ultrasuoni e l'indice di Jhamaria nella diagnosi dell'osteoporosi senile.

Over 90% of the calcaneum is made of trabecular bone, whose turnover is high and which is therefore very sensitive to bone metabolism changes. Thus, we evaluated the mineral content of the calcaneum with the semiquantitative Jhamaria index adapted by Aggarwal et al. (1986) and ultrasound measurements. With the latter method, broadband ultrasound attenuation (BUA) values were calculated, which indicate ultrasound signal breadth reduction when passing through the bone. The two techniques were used to examine 99 women, whose age ranged 65-79 years, referred for dorsolumbar pain and suspected senile osteoporosis. This condition was diagnosed with dorsolumbar spine radiographs and considering as osteoporotic only the patients with one or more vertebral collapses. Thus, any other cause of osteopenia was excluded with bone metabolism serourinary indices. The two groups of patients thus obtained (group A: 42 osteoporotic women with vertebral collapse and group B: 57 osteoporotic women with no vertebral collapse) exhibited significantly different Jhamaria index and BUA values (group A: 2.5 +/- 0.9, B: 3.7 +/- 0.96, A: 46.3 +/- 13.6, B: 60.2 +/- 15.6) (p <0.001). The diagnostic accuracy of calcaneal BUA and Jhamaria indices, in the two groups, was 85.7% and 81%, respectively. The analysis of the mean values showed no significant correlation between BUA and Jhamaria index in the group of patients with vertebral collapse. On the contrary, the correlation of the two indices in the group of patients with no vertebral collapse exhibited slight statistical significance (r = 0.38). To conclude, on the basis of our results the calcaneum is confirmed as a reliable peripheral index of vertebral BMC and ultrasound measurements are suggested as a simple noninvasive method which can be used to diagnose senile osteoporosis.