Perspectives: Ultrasound assessment of bone

HE CLINICAL MANAGEMENT of osteoporosis relies heavily T on the use of bone mass measurements. To this end, several safe, precise, and accurate methods have been developed. All of these use some form of ionizing radiation, and the measurement obtained is a reading of the attenuation of a beam of energy as it passes through bone and soft tissues. Although bone mass shows a high correlation with bone strength, as much as 25-30% of the observed variation in bone strength may be due to the cumulative and synergistic effects of other factors, such as bone microstructure, architecture, and state of remodeling.''.') Bone mass measurements are incapable of measuring directly the effects of any of these factors on bone. In particular, a measure of the biomechanical competence of the skeleton cannot be obtained using these techniques. To determine how bone will respond to mechanical loads, the risk that a particular bone will fracture, and how the skeleton will be altered by a specific drug treatment, a noninvasive method for assessing bone integrity is needed. The use of acoustic energy in the form of an ultrasound wave has been suggested as possibly contributing to the achievement of these