Which skeletal site is the only validated site for the clinical use of QUS in osteoporosis?

• A. Wrist
• B. Heel
• C. Spine
• D. Pelvis

Answer: (B)

The heel is the only validated site for the clinical use of quantitative ultrasound (QUS) in osteoporosis assessment. This validation is based on extensive research demonstrating that heel QUS measurements can effectively estimate fracture risk and bone density. The anatomy of the heel, specifically the quality of the trabecular bone and the size of the calcaneus, provides reliable information about overall bone health and fracture risk related to osteoporosis.

Using QUS at the heel has several advantages, including portability, ease of use, and the lack of ionizing radiation. These factors contribute to its practicality in both clinical and community settings for the assessment of osteoporosis.

Other skeletal sites, such as the wrist, spine, and pelvis, while important in the context of osteoporosis assessments, have not received the same level of validation for QUS. Wrist measurements can be influenced by other factors such as prior fractures or bone quality, and the spine and pelvis may not consistently reflect peripheral bone status or may require more complex imaging techniques for accurate assessment.