Utility of Singh Index as Screening Test for Osteoporosis

Osteoporosis is a very common skeletal disease. Various methods have been devised for quantitative assessment of the bone mass in osteoporosis. DEXA scan is the gold standard for measurement of bone mineral density at present but use of DEXA for mass screening of osteoporosis in low and middle income population may not be feasible as it is expensive and not easily accessible. The present study was conducted to determine the utility of Singh Index as diagnostic tool in osteoporosis. This was a prospective study. 154 female postmenopausal female subjects were enrolled in the study. The trabecular pattern of upper end of femur was studied and graded according to Singh Index and quantitative assessment of BMD was done by the ultrasound bone densitometry. The mean age was 52.07 years (40 – 80 years). The mean duration since menopause was 10.19 years (1-35 years). More number of subjects (120) were detected normal by Ultrasound BMD then by Trabecular pattern (67 subjects); 30 were detected osteopenic (borderline) by BMD whereas 53 by Trabecular pattern. A significant positive correlation between trabecular pattern and BMD i.e. as trabecular loss increases BMD decreases.i.e. loss of trabeculae signifies decrease in bone mineral density. We conclude that postmenopausal osteoporosis is quite a big problem in India. As prevention by timely detection and early prophylactic nutritional supplementation is the only effective treatment strategy, cost effective and easily accessible tests should be devised to screen population for osteoporosis. If evaluated carefully Singh’s index can be a useful tool in screening osteoporotic patients, as it is relatively inexpensive and easily accessible.