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Title: Velocity of ultrasound in the tibia : an investigation
Author: Bernard, Jason
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2003
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Osteoporosis is an increasingly common condition leading to fragility fractures of bone. It may be age related, or have a secondary cause. Over the past decade, new preventative treatments have arisen, which need to be targeted to the population at highest risk of fracture. To achieve this, bone assessment by densitometry is performed, mainly using large, immobile and expensive scanners, which use a small dose of ionising radiation. New, ultrasound, devices have been designed to be portable, less costly and avoid radiation. The main potential roles of densitometry devices are initial assessment of risk for fracture, follow up to define natural history, to assess response to treatment, and as a surrogate end point to assess efficacy of new preventative treatments. It is not fully understood how ultrasound interacts with bone, nor how alterations to bone as a result of age, disease or treatment will effect ultrasonic measurements. To investigate the interaction of transmitted ultrasound with bone. To investigate how alterations to bone as a result of age, disease or treatment will affect ultrasonic measurements. To assess the likely efficacy of an ultrasound device in any of the main roles of densitometry. This work has shown that ultrasound velocity is a stable and reproducible measure, which is systematically higher in males than females, declines in an age related manner and has the potential to discriminate between individuals with and without certain disease states. Specifically those states are osteoporosis, hyperparathyroidism, hyperglucocorticoidism, and Paget's disease of bone. This work has also shown that ultrasound velocity measurements remain stable over periods of at least three years, in spite of measurable decline of bone mineral density in the same time period. In addition, ultrasound velocity has not shown any change in response to treatment with the bisphosphonate, clodronate, in spite of a measurable rise in bone mineral density. It can be concluded that ultrasonic measurement using the "SoundScan 2000" may be of some use for initial assessment of risk for fracture. The device has shown no potential for use in the other roles of densitometry.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available