Panoramic Radiographs vs. Calcaneus Ultrasonography in Diagnosis of Osteoporosis in Postmenopausal Women
Dr. Apurva Dhruv Khator,
25, Daga Layout, Shilpak Apartments, Nagpur, Maharashtra, India.
Introduction: The risk factors for the development of osteoporosis include ageing, menopause, insufficient consumption of food containing calcium, and decreased physical activity. Dual-energy X-ray Absorptiometry (DXA) and quantitative ultrasound are among the techniques developed to identify individuals with osteoporosis and serve as the gold standard. These methods are very expensive and hence there is a need to develop alternative methods to diagnose osteoporosis in post-menopausal women.
Aim: To evaluate Mental Index (MI) and Mandibular Cortical Index (MCI) by means of panoramic radiographs, and thereby assess osteoporosis in post-menopausal women by comparing with USG-calcaneus and to assess the changes in the serum calcium levels in osteoporosis in post-menopausal women by comparing with USG-calcaneus.
Materials and Methods: A hospital based cross-sectional study was carried out in Department of Oral Medicine and Radiology. Hundred patients were divided into 2 groups, premenopausal (control group) and post-menopausal women (study group). Digital panoramic radiographs were made and MCI and MI were determined. A 2 mL of blood sample was taken from antecubital vein by venipuncture method and serum calcium was estimated. USG-Calcaneus Estimation was done and the speed of sound in m/sec for every patient was also noted.
Results: The sensitivity of cortical quality when compared to USG class was 49.15% while specificity was 90.24%. The positive predictive value was found to be 87.88% while negative predictive value was 55.22%. The mean serum calcium of patients in Pre-menopausal group was 8.91±0.75 (Mean±SD), while in Post-menopausal group the mean serum calcium was 8.98±0.71 (Mean±SD). The difference in two means was statistically insignificant with p-value of 0.6593 (p>0.05) as obtained using t-test for independent samples.
Conclusion: Panoramic radiographs seem to be a promising tool in screening post-menopausal women for osteoporosis. The indices used in the study are readily reproducible and easy to learn.