[Calcium pros and cons. Is QUS available for clinical use? QUS should be used as fracture-risk assessment tool, not as diagnostic tool for osteoporosis].

The large prospective studies of osteoporotic fracture in Europe and the United States have confirmed the utility of calcaneal QUS to predict fracture risk in elderly people. The other side, QUS has unfortunately only a few evidence concerning about usefulness as osteoporosis diagnostic tool in recent reports. For the present, QUS should be used as risk assessment tool of osteoporotic fracture. Because various ultrasound parameters depending on the manufacture are defined, the standardization of these values should be achieved. A large number of normative data have been collect to re-calculate to standardize SOS by the committee of Japan Osteoporosis Society, and age-related change of the standardized Speed of Sound (S-SOS) has been already reported. In this report, the peak value of S-SOS is seen in teenager, and mean of S-SOS in each age are gradually decrease in life. This age related change indicates that fracture risk would be gradually increase in life.