Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Table 1 Advantages and disadvantages of the most commonly used diagnostic methods currently available for the treatment of osteoporosis

Dual- X-ray absorptiometry		Quantitative computed tomography		Quantitative ultrasound
PROS	CONS	PROS	CONS	PROS	CONS
High accuracy	X-rays	True density values	Higher radiation dose than DXA	Quick, cheap and radiation-free devices	Different guidelines for definition of osteoporosis
Assessment on reference sites (spine and hip)	High cost	Discriminates completely trabecular from cortical bone	Limited accessibility	Portable systems	Only peripheral anatomical sites
Several validation studies available in literature	Does not distinguish between cortical and trabecular components	High resolution		Shorter investigation times than DXA	Not directly comparable with the gold standard DXA
	Does not discriminate bone microarchitecture			Useful to investigate bone structural features and elastic properties of bone tissue
	Not useful as a screening tool		Not useful as a screening tool	Useful as a screening tool

DXA: Dual X-ray absorptiometry.