AB1200 From the calcaneus quantitative ultrasonography (QUS) to the femoral radiofrequency echographic multi spectrometry (REMS): non-ionising approaches to diagnosize osteoporosis proposed by f.i.r.m.o. foundation
Authors: L. Cavalli, L. Cianferotti, F. Giusti, G. Gronchi, P. Pisani, M.L. Brandi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The high prevalence of osteoporosis and its insidious development, often silent until a fracture occurs, make it necessary to resort to prevention by promoting early diagnosis and educational programmes for a healthy life style. <h3>Objectives</h3> To develop screening campaigns of the Italian population for the osteoporosis prevention thanks to the collaboration with F.I.R.M.O. Foundation (Fondazione Italiana Ricerca Malattie Ossee).<sup>1</sup> <h3>Methods</h3> An experienced medical staff administered to the afferent people the IOF "One minute risk test" questionnaire, (to detect the presence of clinical risk factors), together with a densitometric examination performed by a portable device aboard a mobile unit, in several Italian cities between 2011 and 2017. The technique employed to assess bone status in 2011 and 2012 was calcaneus Quantitative Ultrasonography (QUS), applied to a peripheral skeletal site, which has been shown as effective in identifying osteoporotic men or post-menopausal women.<sup>2</sup> Although representing a low-cost and accessible approach, the heel measurement of speed of ultrasound (SOS) can be influenced by foot positioning, oedema and temperature.<sup>3</sup> Since 2017, a novel non-invasive densitometric technique is available, which allows to evaluate the axial fragile bone sites (spine and femur). It is Radiofrequency Echographic Multi Spectrometry (REMS), that a multicentric clinical study has been shown to provide parameters highly correlated with DXA ones. <h3>Results</h3> As measured by calcaneus QUS in 7305 subjects, the prevalence rate of osteoporosis was approximately 18.7%, while the 42.6% had a T-score compatible with osteopenia. People with a QUS T-score &lt;−2.5 was recommended to early undergo a DXA at lumbar and femoral sites and a specialistic visit. On the other hand, REMS examinations at femoral neck, performed on 397 people, revealed that osteoporosis resulted in 25% of the sample and osteopenia in 54%. Also in this case, people with a T-score &lt;−2.5 was suggested to perform a DXA, considering that the accuracy and operator-independent automatic analysis performed by REMS, make more reliable the obtained data. <h3>Conclusions</h3> Nowadays, with REMS introduction, F.I.R.M.O. foundation and the health system could avail themselves of a new non-invasive, rapid, easy-to-use and automatized technology for the prevention of osteoporosis. <h3>References</h3> [1] Cavalli L, Guazzini G, Cianferotti L, et al. "Prevalence of osteoporosis in the Italian population and main risk factors: results of BoneTour Campaign". BMC Musculoskeletal Disorders (2016) 17:396; DOI 10.1186/s12891–016–1248–8 [2] Krieg MA, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Del Rio Barquero L, et al. Quantitative ultrasound in the management of osteoporosis: the 2007. ISCD official positions. J Clin Densitom. 2008;11:163 [3] Hans D, Krieg MA. Quantitative ultrasound for the detection and management of osteoporosis. Salud Publica Mex2009;51suppl 1:S25-S37 <h3>Acknowledgements</h3> The authors are grateful to F.I.R.M.O. Foundation for promoting these screening campaigns. <h3>Disclosure of Interest</h3> None declared