Ultrasound scan 

Ultrasound scans may be used to help understand how strong bones are. But they are not a proven way to measure bone strength.

Ultrasound scans are mainly used in research trials looking at bones. And research has not shown if ultrasound results can be used to make decisions about drug treatments for osteoporosis

What is an ultrasound scan and how can it be used on bones? 

Ultrasound scans use sound waves at a high-frequency. You can't hear these sound waves. 

Ultrasound scans are commonly used to monitor pregnancy and look at organs inside the body - such as the stomach, liver, kidneys and blood vessels. 

A small probe is placed on the area of the body being examined. When looking at bone, the probe is usually placed on the heel, wrist or finger. 

The probe transmits sound waves into the body. The sound waves create echoes when they bounce off different parts of the body. These echoes are used to build up an electronic picture of the bone, organ or unborn baby. 

Will I be offered an ultrasound scan? 

Ultrasound scans are not routinely offered on the NHS to look at bone strength. This is because ultrasound is not as well developed as DXA (dual energy x-ray absorptiometry)

Doctors use DXA scan results and a fracture risk assessment to assess your risk of breaking a bone. 

Some private companies offer ultrasound scans as a way of measuring bone strength because the machines are cheaper, smaller and easier to move around than DXA machines. The machines don't use radiation so companies don't need to follow radiation regulations. 

What can ultrasound scan results tell us about bone health?

Ultrasound scan results may tell us some information about how strong your bones are. They may also be able to help assess your risk of breaking a bone in the future. 

Most of the research looking into ultrasound has involved women who are 75 years or over. Some studies showed a link between a low ultrasound result and a risk of breaking a bone in the hip. But we need more evidence to understand what ultrasound results mean. 

Healthcare professionals cannot use ultrasound scan results to make decisions about drug treatments. This is because results are hard to interpret and compare with DXA scan results. 

A low ultrasound result might mean you are at risk of osteoporosis and breaking a bone easily. 

If you have had an ultrasound scan, and have a low result, you may want to discuss your risk with your doctor. They may refer you for a DXA scan if you have other risk factors for osteoporosis and broken bones 

REMS (Radio-frequency echogenic multi-spectrometry)

REMS is a similar technology to ultrasound. It uses sound and radio waves to measure how strong your bones are. 

Some private clinics offer REMS. But it is not routinely offered on the NHS. 

REMS is a new technology and we don't know how reliable it is yet. Research has not shown if people with a low REMS score are likely to break a bone easily in the future. It's also not possible to compare REMS scan results with DXA scan results. 

Content reviewed: August 2023

Watch our discussion on DXA and other osteoporosis scans: 

You may be interested in watching a conversation with consultant radiographer, Jill Griffin, who discussed the different types of scans for osteoporosis. This film is part of our #BoneMatters series of events