Noninvasive assessments of bone strength.
OBJECTIVE
Description of new noninvasive technologies or modifications of existing technologies with which individual components of bone strength and bone strength as a whole can be quantified.


RESULTS
Although bone mineral density has served as an able surrogate for bone strength, it is clear that aspects of bone strength are either not captured or are not discernible within the measurement of bone density. New, noninvasive technologies have been developed to quantify aspects of bone strength such as biomechanical parameters based on geometry and scale and topological parameters of microarchitecture. Finite element modeling utilizes sophisticated mathematical approaches to predict the strength of the whole bone. At present, most of these technologies remain beyond the reach of clinicians, with the exception of hip structural or strength analysis.


CONCLUSIONS
Hip strength or structural analysis is widely available because of its incorporation with dual energy X-ray absorptiometry and has been extensively used in clinical research. None of these new approaches has been shown to be superior to the measurement of bone density in the prediction of fracture risk. This fact does not diminish their potential to enhance the understanding of the pathophysiology of fracture and the mechanisms of therapeutic efficacy.
Bonnick
Sydney Lou
SL
Clinical Research Center of North Texas, Denton, Texas 76210, USA. sbonnickcrcnt@verizon.net
D015502:Absorptiometry, Photon; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D019245:Compressive Strength; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D020342:Finite Element Analysis; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008954:Models, Biological; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed