According to the WHO criteria for diagnosing osteoporosis, DXA is presently the best method for
measuring and diagnosing osteoporosis, but it is relatively expensive, non-portable and emits low-level
radiation. Alternatively, the Osteoporosis Risk Assessment Tool for Asians (OSTA) and quantitative
ultrasound (QUS) are simpler, less expensive and emit no radiation, but are less accurate. However, the use of
OSTA index corroborated by QUS was proposed as an alternative method of diagnosing osteoporosis. The
combined diagnostic strength of an OSTA index < -1 and a QUS T-score < -4.5 had comparably high accuracy
relative to the gold standard DXA T-score < -2.5, especially for the femoral neck (80%) and total femur (89%).
We conclude that the sequential use of the OSTA index followed by QUS is an efficacious alternative for
diagnosing osteoporosis, especially in rural areas or in developing countries where resources are limited.

Keywords: Asian continental ancestry group, Absorptiometry, Photon, Osteoporosis, Ultrasonography