The role of ultrasound in the assessment of osteoporosis: A review

Osteoporosis International

Volumn 7, Issue 1, 1997, Pages 7-22

  Njeh, C F ^a,c   Boivin, C M ^a   Langton, C M ^b  

^a UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST   (United Kingdom)

^b UNIVERSITY OF HULL   (United Kingdom)

^c QUEEN ELIZABETH HOSPITAL   (United Kingdom)

Author keywords

Bone mineral density (BMD); Bone structure; Broadband ultrasound attenuation (BUA); Fracture; Osteoporosis; Quantitative ultrasound (QUS); Speed of sound (SOS)

Indexed keywords

BONE DENSITY; BONE STRUCTURE; CALCANEUS; DIAGNOSTIC ACCURACY; DIAGNOSTIC VALUE; DUAL ENERGY X RAY ABSORPTIOMETRY; ECHOGRAPHY; HIP FRACTURE; HUMAN; INFORMATION PROCESSING; INTERMETHOD COMPARISON; OSTEOPOROSIS; PHOTON ABSORPTIOMETRY; PREDICTION; PRIORITY JOURNAL; QUANTITATIVE DIAGNOSIS; REVIEW; SPINE;

EID: 0031040692     PISSN: 0937941X     EISSN: None     Source Type: Journal    
DOI: 10.1007/BF01623454     Document Type: Review

References (128)

1. Stevenson JC, Whitehead MI. Postmenopausal osteoporosis. BMJ 1982;285:585-8.
2. Tothili P. Methods of bone mineral measurements. Phys Med Biol 1989;34:543-72.
3. Sim LH, van Doom T. Radiographic measurement of bone mineral: reviewing dual-energy X-ray absorptiometry. Aust Phys Eng Sci Med 1995;18:65-80.
4. Alhava ME. Bone density measurement. Calcif Tissue Int 1991; (suppl) 49:S21-3.
5. Lang P, Steiger P, Faulkner K, Gluer C, Genant HK. Current techniques and recent developments in quantitative bone densitometry. Radiol Clin North Am 1991;29:49-76.
6. Ostlere SJ, Gold RH. Osteoporosis and bone density measurement methods. Clin Orthop 1991;271:149-63.
7. Kleerekoper M, Villaneuva AR, Stanciu J, Rao DS, Parfit AM. The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fracture. Calcif Tissue Int 1985;37:594-97.
8. Mosekilde L. Sex differences in age-related loss of vertebral trabecular bone mass and structure: biomechanical consequences. Bone 1989;10:425-32.
9. Marcus R. Understanding osteoporosis. West J Med 1991;155:53-60.
10. Gluer CC, Wu CY, Genant HK. Broadband attenuation signals depend on trabecular orientation: an in-vitro study. Osteoporosis Int 1993;3:185-91.
11. Tavakoli MD, Evans JA. Dependence of the velocity and attenuation in bone on the mineral content. Phys Med Biol 1991,36 1529-37.
12. Hans D, Schott AM, Meunier PJ. Ultrasonic assessment of bone: a review. Eur J Med 1993;2:157-63.
13. Kaufman JJ, Einhorn TA. Perspectives: ultrasound assessment of bone. J Bone Miner Res 1993;8:517-24.
14. Pain HJ. The physics of vibrations and waves. Chichester: Wiley, 1985.
15. Njeh CF. The dependence of ultrasound velocity and attenuation on the material properties of cancellous bone. PhD thesis, Sheffield Hallam University, UK, 1995.
16. Breazeale MA, Cantrell JH, Heyman JS. Ultrasonic wave velocity and attenuation measurements. Methods Exp Phy 1981;19:67-135
17. Hans D, Schott AM, Arlot ME, Sornay E, Delmas PD, Meunier PJ. Influence of anthropometric parameters on ultrasound measurements of os calcis. Osteoporosis Int 1995;5:371-6.
18. Kotzki PO, Buyck D, Hans D, Thomas E, Bonnel F, Favier F, Meunier PJ, Rossi M. Influence of fat on ultrasound measurements of the os calcis. Calcif Tissue Int 1994;54:91-5.
19. Miller CG, Herd RJM, Ramalingam T, Fogelman I Blake GM. Ultrasonic velocity measurements through the calcaneus: which velocity should be measured? Osteoporosis Int 1993;3:31-5.
20. Bamber JC, Tristam M. Diagnostic ultrasound. In: Webb S, editor. The physics of medical imaging. Bristol: Adam Hilger, 1988:319-86.
21. Kinsler LE, Frey AR, Coppens AB, Sanders JV. Fundamentals of acoustics. New York: Wiley. 1992.
22. Langton CM, Palmer SB, Porter RW. The measurement of broadband ultrasonic attenuation in cancellous bone. Eng Med 1984;13:89-91.
23. Wu CY, Gluer CC, Jersas M, Bendavid E, Genant HK. The impact of bone size on broadband ultrasound attenuation. Bone 1995;16:137-41.
24. Serpe LJ, Rho J. Broadband ultrasound attenuation value dependence on bone width in vitro. Phys Med Biol 1996;41:197-202.
25. Bouxsein ML, Radloff SE, Toledano TR, Haves WC. Calcaneal ultrasound measurements are moderately correlated with trabecular bone density and independent of foot geometry. J Bone Miner Res 1994:9(Suppl 1): S208.
26. Blake GM, Herd RJM, Miller CG. Should broadband ultrasonic attenuation be normalized for the width of the calcaneus? Br J Radiol 1994;67:1206-9.
27. Vogel JM, Wasnich RD, Ross PD. The clinical relevance of calcaneus bone mineral measuremnets: a review. Bone Miner 1988;5:35-58.
28. Wasnich RD, Ross PD, Heilbrun LK, Vogel JM. Selection of the optimal skeletal site for fracture prediction. Clin Orthop 1987;216:262-9.
29. Black DM, Cummings SR, Genant HK, Nevitt MC, Palermo L, Browner W. Axial and appendicular bone density predict fractures in older women. J Bone Miner Res 1992;7:633-8.
30. Simkin A. Ultrasonic velocity along the tibial shaft as a diagnostic tool for osteoporosis and a predictor of hip fractures. Myriad Ultrasound Systems Ltd, 1993.
31. Mele R. Determinazione delle caratteristiche strutturali densitometriche del tessuto osseo mediante ultrasuoni. Atti della Societa Emiliana Romagnola Triveneta di Ortopedia e Traumatologia 1993;35(1):1-4.
32. Boivin CM, Njeh CF, Bulmer N, Lilley J, Delvin J, Emery P. Finger ultrasound in assessment of rheumatoid arthritis. In Zhonghou L et al., editors. Advances in osteoporosis. International Academic Publishers, 1995:392-3.
33. Truscott JG, Simpson M, Stewart SP, et al. Bone ultrasonic attenuation in women: reproducibility, normal variation and comparison with photon absorptiometry. Clin Phys Physiol Meas 1992;13:29-36.
34. Waud CE, Lew R, Baran DT. The relationship between ultrasound and densitometric measurements of bone mass at the calcaneus in women. Calcif Tissue Int 1992;51:415-8.
35. Evans JA, Tavakoli MB. Temperature and direction dependence of the attenuation and velocity of ultrasound in cancellous and cortical bone. In: Ring EFG, Bhalla AK editors. Current research in osteoporosis and bone measurement II. Bath: British Institute of Radiology, 1992.
36. Zagzebski J, Rossman P, Mesina C, Mazess R, Madsen E. Ultrasonic transmission measurements through the os calcis. Calcif Tissue Int 1991;49:107-11.
37. Mazess R, Trempe J, Barden H. Ultrasound measurement of the os calcis. Calcif Tissue Int 1993;52:S165.
38. Lees B, Stevenson JC. Preliminary evaluation of a new ultrasound bone densitometer. Calcif Tissue Int 1993;53:149-52.
39. Langton CM, Ali AV, Riggs CM, Evans GP, Bonfield W. A contact method for the assessment of ultrasonic velocity and broadband attenuation in cortical and cancellous bone. Clin Physiol Meas 1990;11:243-49.
40. Orgee JM, Foster H, McCloskey EV, Khan S, Coombes G, Kanis JA. A precise method for the assessment of tibial ultrasound velocity. Osteoporosis Int 1996;6:1-7.
41. Gluer CC, Wu C, Genant HK. Disparity of different BUA approaches. Calcif Tissue Int 1993;52:S171.
42. Graafmans WC, Lips P, Lingen AV, Bouter LM. Ultrasound measurements in the calcaneus: reproducibility and its relation with bone mineral density. In: Ring EFJ, Elvins DM, Bhalla AK, editors. Current research in osteoporosis and bone mineral measurements III. British Institute of Radiology, 1994:19.
43. Mazess R, Morris R, Trempe J. Recent advances in ultrasound densitometry: the Achilles Plus. Industry Forum, 11th international bone densitomerty workshop, Oregon, Sept 24-28, 1995.
44. Ramalingam T, Herd RJM, Lees B, Blake GM, Stevenson JC, Miller CG, Fogelman I. A comparison of three commercial bone ultrasound scanners (abstract). Calcif Tissue Int 1993;52:170.
45. Evans WD, Jones EA, Owen GM. Factors affecting the in vivo precision of broadband ultrasonic attenuation. Phys Med Biol 1995;40:137-51.
46. Abendschein W, Hyatt GW. Ultrasonics and selected physical properties of bone. Clin Orthop 1970;69:294-301.
47. Behari J, Singh S. Ultrasound propagation in in vivo bone. Ultrasonics 1981;81:87-90.
48. Andre MP, Craven JD, Greenfield MA. Measurement of the velocity of ultrasound in the human femur in vivo. Med Phys 1980;7:324-30.
49. Greenfield MA, Craven JD, Huddleston A, Kehrer ML, Wishko D, Stern R. Measurement of the velocity of ultrasound in human cortical bone in vivo. Radiology 1981;138:701-10.
50. Fry FJ, Barger JE. Acoustical properties of human skull. J Acoust Soc Am 1978;63:1576-90.
51. Ashman RB, Corin JD, Turner CH. Elastic properties of cancellous bone measurement by an ultrasonic technique. J Biomech 1987;20:979-86.
52. Turner CH, Eich M. Ultrasonic velocity as a predictor of strength in bovine cancellous bone. Calcif Tissue Int 1991;49:116-9.
53. Evans JA, Tavakoli MB Ultrasonic attenuation and velocity in bone. Phys Med Biol 1990;35:1387-96.
54. Njeh CF, Hodgskinson R, Langton CM. Determination of bone strength from ultrasonic velocity and broadband ultrasound attenuation. Br J Radiol 1995;68:789.
55. Bouxsein ML, Radloff SE, Hayes WC. Quantitative ultrasound of the calcaneus reflects trabecular bone strength, modulus and morphology. J Bone Miner Res 1995; 10(Suppl 1):S175.
56. Rubin CT, Pratt GW, Porter AL, Lanyon LE, Poss R. The use of ultrasound in vivo to determine acute change in the mechanical properties of bone following intense physical activity. J Biomech 1987;20:723-7.
57. Heaney RP, Avioli LV, Chestnut CH, Lappe J, Rescker RR, Brandenburger GH. Osteoporotic bone fragility, detection by ultrasound transmission velocity. JAMA 1989;261:2986-90.
58. Rossman P, Zagzebski J, Mesina C, Sorenson J, Mazess R. Comparison of speed of sound and ultrasound attenuation in the os calcis to bone density of the radius, femur and lumbar spine. Clin Physiol Meas 1989;10:353-60.
59. Turner CH, Peacock M, Timmerman L, Neal JM, Johnston CC Jr. Calcaneal ultrasonic measurements discriminate hip fractures independently of bone mass. Osteoporosis Int 1995;5 130-5.
60. Schott AM, Weill-Engerer S, Hans D, Duboeuf F, Delmas PD, Meunier PJ. Ultrasound discriminates patients with hip fracture equally well as dual-energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 1995;10:243-9.
61. Wuster C, Paetzold W, Scheidt-Nave C, Brandt K, Ziegler R. Equivalent diagnostic validity of ultrasound and dual x-ray absorptiometry in a clinical case-comparison study of women with vertebral Osteoporosis. J Bone Miner Res 1994;9(Suppl 1):S211.
62. Gonnelli S, Cepollaro C, Agnusdei D, Palmieri R, Rossi S, Gennari C. Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenopausal women. Osteoporosis Int 1995;5:413-8.
63. Stegman MR, Heaney RP, Recker RR. Comparison of speed of sound ultrasound with single photon absorptiometry for determining odds ratio. J Bone Miner Res 1995;10:346-52.
64. Heaney RP, Avioli LV, Chesnut CH, Lappe J, Recker RR, Brandenburger GH. Ultrasound velocity through bone predicts incident vertebral deformity. J Bone Miner Res 1995;10:341-5.
65. Stegman MR, Heaney RP, Travers-Gustafson D, Leist J. Cortical ultrasound velocity as an indicator of bone status. Osteoporosis Int 1995;5:349-53.
66. Orgee J, McCloskey EV, Foster H, Coombes G, Khan S, Kanis JA. Tibial ultrasound velocity: a useful clinical measure of skeletal status. J Bone Miner Res 1994;9:S156.
67. Hans D, Dargent P, Schott AM, et al. Ultrasound parameters predict hip fracture independently of hip bone density: the EPIDOS prospective study. J Bone Miner Res 1995;10(Suppl): S169.
68. Garcia BJ, Foster FS, McNeill RG. Ultrasonics attenuation in bone. Ultrasonics symposium proceedings. 1978:327-30
69. Smith SW, Phillips DJ, Von Ramm OT, Thurstone FL. Some advances in acoustic imaging through the skull: In: Linzer M. editor. Ultrasonic tissue characterization II. Washington: National Bureau of Standards Special Publication 525:1979:209-217.
70. McCloskey EV, Murray SA, Charlesworth D, et al. Assessment of broadband attenuation in the os calcis in vitro. Clin Sci 1990;78:221-5.
71. McKelvie ML, Fordham J, Clifford C, Palmer SW. In vitro comparison of quantitative computer tomography and broad-band ultrasonic attenuation of trabecular bone. Bone 1989;10:101-4.
72. Langton CM, Njeh CF, Hodgskinson R, Currey JD. Prediction of mechanical properties of the human calcaneus by broadband ultrasonic attenuation. Bone 1996;18:495-503.
73. Bouxsein ML, Courtney AC, Hayes WC. Ultrasound and densitometry of the calcaneus correlate with the failure loads of cadaveric femurs. Calcif Tissue Int 1995;56:99-103.
74. Ross P, Huang C, Davis J, et al. Predicting vertebral deformity using bone densitometry at various skeletal sites and calcaneus ultrasound. Bone 1995;16:325-32.
75. Kleerekoper M, Nelson DA, Flynn MJ, Pawluszka AS, Jacobsen G, Peterson EL. Comparison of radiographic absorptiometry with dual-energy X-ray absorptiometry and quantitative computed tomography in normal older white and black women. J Bone Miner Res 1994;9:1745-9.
76. Gluer CC, Vahlensieck M, Faulkner KG, Engelke K, Black D, Genant HK. Site-matched calcaneal measurement of broadband ultrasound attenuation and single X-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res 1992;7:1071-9.
77. Brandenburger GH. Clinical determination of bone quality: is ultrasound an answer? Calcf Tissue Int 1993;53(Suppl 1):S151-6.
78. Faulkner KG, McClung MR, Coleman LJ, Kingston-Sandahl E. Quantitative ultrasound of the heel: Correlation with densitometric measurements at different skeletal sites. Osteoporosis Int 1994;4:42-7.
79. Armitage P, Berry G. Statistical methods in medical research. Oxford: Blackwell Scientific Publications, 1987.
80. Langton CM. The role of ultrasound in the assessment of osteoporosis. Clin Rheumatol. 1994;13(Suppl 1):13-7.
81. Resch H, Pietschmann P, Bernecker P, Krexner E, Wilvonseda R. Broadband ultrasound attenuation: a new diagnostic method in osteoporosis. AJR 1990;155:825-8.
82. Herd RJM, Ramalingham T, Ryan PJ, Fogelman I, Blake GM. Measurements of BUA in the calcaneus in premenopausal and postmenopausal women. Osteoporosis Int 1992;2:247-51.
83. Damilakis JE, Drekatis E, Courtsoyiannis NC. Ultrasound attenuation of the calcaneus in female population: normative data. Calcif Tissue Int 1992;51:180-3.
84. Baran DT, Kelly AM, Karellas A, et al. Ultrasonic attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif Tissue Int 1988;43:138-42
85. McCloskey EV, Murray SA, Miller C, et al. Broadband ultrasound attenuation in the os calcis: relationship to bone mineral at other skeletal sites. Clin Sci 1990;78:227-33.
86. Agren M, Karellas A, Leahey D, Marks S, Baran DT. Ultrasound attenuation of the calcaneus: a sensitive and specific discriminator of osteopenia in postmenopausal women. Calcif Tissue Int 1991;48:240-4.
87. Funke M, Kopka L, Vosshenrich R, Fischer U, Ueberschaer A, Oestmann JW, Grabbe E. Broadband ultrasound attenuation in the diagnosis of osteoporosis. correlation with osteodensitometry and fracture. Radiology 1995;194:77-81.
88. Stewart A, Reid DM, Porter RW. Broadband ultrasound attenuation and dual energy X-ray absorptiometry in patients with hip fractures: which technique discriminates fracture risk? Calcif Tissue Int 1994;54:466-9.
89. Orwoll ES, Oviatt SK, Mann T. The impact of osteophytic and vascular calcification on vertebral mineral density measurement in men. J Clin Endocrinol Metab 1990;70:1202-7
90. Stewart A, Felsenberg D, Kalidis L, Reid DM. Vertebral fractures in men and women: how discriminative are bone mass measurements? Br J Radiol 1995;68:614-20.
91. Bauer DC, Gluer CC, Genant HK, Stone K. Quantitative ultrasound and vertebral fracture in postmenopausal women. J Bone Miner Res 1995;10:353-8.
92. Dretakis EC, Kontakis GM, Steriopoulos CA, Dretakis CE. Decreased broadband ultrasound attenuation of the calcaneus in women with fragility fracture. Acta Orthop Scand 1994;65:305-8.
93. Kroger H, Jurvelin J, Amala I, et al. Ultrasound attenuation of the calcaneus in normal subjects and in patients with wrist fracture. Acta Orthop Scand 1995;66:47-52.
94. Porter RW, Miller CG, Grainger D, Palmer SB. Prediction of hip fracture in elderly women: a prospective study. BMJ 1990;301:638-41.
95. Bauer DC, Gluer CC, Pressman AR, et al. Broadband ultrasonic attenuation (BUA) and the risk of fracture: a prospective study. J Bone Miner Res 1995;10(Suppl 1):S175.
96. Gluer CC, Fuerst T, Wu CY, et al. Diagnostic sensitivity of various quantitative ultrasound and dual x-ray absorptiometry approaches. J Bone Miner Res 1995, 10(Suppl 1):S373.
97. Fordham JN, Langton CM, Tulsidas H. Ultrasonic measurements of bone density in rheumatoid arthritis and osteoarthritis. In: Palmer SB, Langton CM, editors. Ultrasonic studies of bone. Bristol: IOP Publication, 1987:47-53.
98. Nijs J, Boonen S, Geusens P, Borghs H, Dequeker J. Ultrasound in osteoarthritis and osteoporosis. In: Ring EF, Elvins DM, Bhalla AK, editors. Current research in osteoporosis and bone mineral measurement III. Bath: British Institute of Radiology, 1994:45.
99. Acotto CG, Schott AM, Hans D, Njepomniszeze H, Mautalen CA, Meunier PJ. Hyperthyroidism influences ultrasound bone measurements of the calcaneus. J Bone Miner Res 1995; 10(Suppl 1):S400.
100. Jones PRM, Hardman AE, Hudson A, Norgan NG. Influence of brisk walking on the broadband ultrasonic attenuation of the calcaneus in previously sedentary women aged 30-61 years. Calcif Tissue Int 1991;49:112-5.
101. Herd RJM, Blake GM, Ramalingham T, Miller CG, Ryan PJ, Fogelman I. Measurements of postmenopausal bone loss with a new contact ultrasound system. Calcif Tissue Int 1993;53:153-7.
102. Rosenthall L, Tenenhouse A, Caminis J. A correlative study of ultrasound calcaneal and dual-energy x-ray absorptiometry bone measurements of the lumbar spine and femur in 100 women. Eur J Nucl Med 1995;22:402-6.
103. Langton CM, Evans GP, Hodgskinson R Riggs CM. Ultrasonic, elastic and structural properties of cancellous bone. In: Ring EFG, editor. Current research in osteoporosis and bone mineral measurement. Bath: British Institute of Radiology, 1990.
104. Nicholson PHF, Haddaway MJ, Davie MW. The dependence of ultrasonic properties on orientation in human vertebral bone. Phys Med Biol 1994;39:1013-24
105. Tavakoli MB, Evans JA. The effect of bone structure on ultrasonic attenuation and velocity. Ultrasonics 1992;30:389-95.
106. Hans D, Arlot ME, Shott AM, Roux JP, Kotzki PO, Meunier PJ Do ultrasound measurements on the os calcis reflect more bone microarcitecture than the bone mass? A two-dimensional histomorphometric study Bone 1995;16:295-300.
107. Gluer CC, Wu CY, Jergas M, Goldstein SA, Genant HK. Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int 1994;55:46-52.
108. Laugier P, Giat P, Berger G. New ultrasonic methods of quantitative assessment of bone status. Eur J Ultrasound 1994;1:23-38.
109. Petley GW, Robins PA, Aindow JD. Broadband ultrasonic attenuation: are current measurement techniques inherently inaccurate? Br J Radiol 1995;68:1212-4.
110. Laugier P, Giat P, Berger G. Broadband ultrasonic attenuation imaging: a new imaging technique of the os calcis. Calcif Tissue Int 1994;54:83-6.
111. Roux C, Fournier B, Laugier P. et al. Ultrasound bone imaging: clinical evaluation of skeletal status. Osteoporosis Int 1996;6:84.
112. Langton CM. Electronic phantom for the ultrasonic assessment of bone. Osteoporosis Int 1996;6:87.
113. Njeh CF, Langton CM. Prediction of bone strength from ultrasound velocity and apparent density. Osteoporosis Int 1996;6:83.
114. Hans D, Dargent P, Schott AM et al. Which ultrasound parameters could be combined with DXA to provide a better prediction of hip fracture in the elderly? The EPIDOS prospective study. Osteoporosis Int 1996;6:84.
115. Gnudi S, Malavolta N, Ripamonti C, Caudarella R Ultrasound in the evaluation of Osteoporosis: a comparison with bone mineral density at distal radius. Br J Radiol 1995;68:476-80.
116. Wapniarz M, Lehmann R, Banik N, Radwan M, Klein K, Allolio B. Apparent velocity of ultrasound (AVU) at the patella in comparison to bone mineral density at the lumbar spine in normal males and females. Bone Miner 1993;23:243-52.
117. Fujii Y, Goto B, Takahashi K, Fujita T. Ultrasound transmission as a sensitive indicator of bone change in Japanese women in the perimenopausal period. Bone Miner 1994;25:93-101.
118. Foldes AJ, Rimon A, Keinan DD, Popovtzer MM. Quantitative ultrasound of the tibia: a novel approach for assessment of bone status. Bone 1995;17:363-7.
119. Herd RJM, Blake GM, Miller CG, Parker JC, Fogelman I. The ultrasonic assessment of osteopenia as defned by dual x-ray absorptiometry. Br J Radiol 1994;67:631-5.
120. Schott AM, Hans D, Sornay-Rendu E, Delmas PD, Meunier PJ. Ultrasound measurements on os calcis: precision and age-related changes in a normal female population. Osteoporosis Int 1993;3:249-54.
121. Salamone LM, Krall EA, Harris S, Dawson-Hughes B. Comparison of broadband ultrasound attenuation to single x-ray absorptiometry measurements at the calcaneus in postmenopausal women. Calcif Tissue Int 1994;54:87-90.
122. Evans WD, Crawley EO, Compston JE, Evans C, Owen GM. Broadband ultrasonic attenuation and bone mineral density (letter). Clin Phys Meas 1988;9:163-5
123. Petley GW, Hames TK, Cooper C Langton CM, Cawley MD. A comparison of single photon absorptiometry and broadband ultrasonic attenuation: past, present and future. In: Palmer SB, Langton CM, editors. Ultrasonics studies of bone. Institute of Physics Short Meetings no. 6, 1987.
124. Hosie CJ, Smith DA, Deacon AD, Langton CM. Comparison of broadband ultrasonic attenuation of the os calcis and quantitative computed tomography of the distal radius. Calcif Tissue Int 1987;48:303-8.
125. Poll V, Cooper C, Cawley MID. Broadband ultrasonic attenuation in the os calcis and single photon absorptiometry in the distal forearm: a comparative study. Clin Phys Physiol Meas 1986;7:375-9.
126. Massie A, Reid DM, Porter RW. Screening for osteoporosis: comparison between dual-energy X-ray absorptiometry and broadband ultrasound atenuation in 100 perimenopausal women. Osteoporosis Int 1993;3:107-10.
127. Young A, Howey S, Purdie DW. Broadband ultrasound attenuation compared with dual-energy X-ray absorptiometry in screening for postmenopausal low bone density. Osteoporosis Int 1993;3:160-4.
128. Baran DT, McCarthy CK, Leahey D, Lew R. Broadband ultrasound attenuation of the calcaneus predicts lumbar and femoral neck density in caucasian women: a preliminary study. Osteoporosis Int 1991;1:110-3.