Quantitative ultrasonometry for the diagnosis of osteoporosis in human skeletal remains: New methods and standards

Osteoporosis, a complex and heterogeneous disorder with a multi-factorial etiology, is characterized by abnormal bone loss leading to an increased risk of fractures. In recent years, the study of osteoporosis and bone mineral quality has received increasing interest by biological anthropologists. In particular, the study of bone quality in ancient populations in relation to sex, age and cultural background can provide important insights into the diachronic evolution of a seemingly modern pathology. However, a number of challenges remain in the determination of bone loss in ancient remains, partly due to the methodological approaches applied in the anthropological analysis. This underlines the need for a new methodology and new standards, specifically created and adapted to human skeletal remains. The current study aims to develop a new methodology to assess bone quality in modern and ancient human skeletal remains using Quantitative Ultrasonometry, applied for the first time to a skeletal sample of known age-at-death and sex (Frassetto collection, University of Bologna). After the assessment of intra-and inter-observer reliability, new ultrasonometric standards based on the analysis of age-related and sex-related changes in bone quantity and quality were created, providing a reference point for the analysis of osteoporosis and bone loss in skeletal remains. The applicability of the method was tested in a medieval sample including both males and females. The low intra- and inter-observer errors suggest that the Phalangeal Ultrasonometry is a reliable and valid technique that can be applied to modern and ancient human skeletons.