Ultrassonografia de calcâneo e de falange no diagnóstico da osteoporose
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2016-04-16
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Universidade Federal de Goiás
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Introduction: Resulting from changes in bone remodeling process osteoporosis
affects a large segment of the adult population. According to Ministry of Health data
in Brazil are spent on average with hip fractures due to osteoporosis, 28 million reais
per year. The gold standard for diagnosis and DXA (Dual Energy X-ray
Absorptiometry) but doubts remain whether the BMD (Bone Mineral Density) by
means of this standard is the best way to diagnose osteoporosis and predict fracture
risk. Objectives: Make an osteoporosis on review article entitled "Physiology of
Osteoporosis. Establish the sensibility of ultrasound in screening for osteoporosis
from Ultrasonometry the calcaneus (USQC) in relation to the gold standard DXA.
Establish the sensitivity of ultrasonography in screening for osteoporosis based on
bone quality by Ultrasonometry Phalange (USQF) in relation to the gold standard
DXA. Establish the sensitivity of ultrasonography in screening for osteoporosis based
on bone quantity of USQF in relation to the gold standard DXA. Methods: A survey
was conducted in PUBMED, MEDLINE, BVS / LILACS with the key words:
osteoporosis, epidemiology and pathophysiology. We selected 80 articles and after
reading these, we selected 25 articles published in the last 10 years. For diagnostic
tests used a descriptive study consists of sample of 125 women between 30 and 90
years who underwent screening BMD through USQC, in the period between 13 and
23 May 2013 and after accepting participate and sign the Informed Consent and
were referred to the realization of USQF and the gold standard DXA spine and
femur Results: At USQC in relation to the column of DXA: S=16%, E=97%,
VPP=57%, VPN=82% and accuracy of 80% in relation to the femur DXA: S=42,8%,
E=97%, VPP=43%, VPN=96% and accuracy of 93%. In bone quality UBPI
(Ultrassoud and Bone Profile Index) versus column DXA: S=68%, E=82%,
VPP=48%, VPN=91% and accuracy of 79% and the femur DXA: S=77%, E=75%,
VPP=17%, VPN=99% and accuracy of 76%. Bone quantity USQF relative to Column
DXA: S=77% E=83%, VPP=54%, VPN=93 and accuracy of 81% and in relation to
the femur DXA: S=100%, E=75%, VPP=19%, VPN=100% and accuracy 76%. Bone
quantity USQC relative to USQF: S=14%, E=95.5%, VPP=50%, VPN=74% and
accuracy of 72%. Discussion: Diagnostic tests are used to assess the commitment
of the skeleton and check the presence of bone deterioration. The quantitative
diagnostic test of calcaneal ultrasound compared to the column DXA and femur
showed little sensitive to identify bone deterioration considering that the sample
included women outside the risk group and this test is effective when carried out in
over 60 patient years. The quality parameter UBPI and bone quantity USQF
demonstrated to be sensitive and specific, especially in relation to the femur DXA
with sensibility equal to the gold standard. Conclusion: The ultrasound of calcaneus
had no relevance in screening or diagnosis of osteoporosis as compared to the gold
standard DXA spine and femur in this study. The phalanx of Ultrasonography
considering bone quality was an important factor in the screening or diagnosis of
osteoporosis, especially when compared to the femur DXA. The phalanx ultrasound
quantification of bone mass had relevance to the evaluation or diagnosis of
osteoporosis column and especially in the femoral osteoporosis.
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SOUSA SILVA, Maria Rita de. Ultrassonografia de calcâneo e de falange no diagnóstico da osteoporose. 2016. 93 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2016.