Osteoporosis is a metabolic disorder that results in a decrease in bone mineral density and an alteration in the trabecular architectural structure. Osteoporotic bone has decreased mechanical strength making it prone to fracture, especially atraumatic vertebral fractures and fall-related hip and radius fractures. Osteoporosis is clinically diagnosed using measurement of bone mineral density. Bone mineral density is usually measured using x-ray or ultrasound imaging techniques. In x-ray imaging (such as dual energy x-ray absoptiometry, DEXA, and quantitative computer tomography, QCT) the image intensity relates to the tissue mineral density. In ultrasound, image intensity reflects the change in frequency and amplitude of the sound wave traveling through the tissue. X-ray techniques use ionizing radiation, which can have deleterious effects in sufficient doses. Ultrasound, though harmless, provides only a small field of view, which may limit the accuracy of the measurement. In addition to bone density, the quality of bone which includes bone micro-architecture is of interest. Recent advances in micro-computed tomography, a x-ray based 3D technique has made it possible to obtain images of trabecular bone micro-architecture. Another promising imaging modality for measurement of trabecular architecture is magnetic resonance imaging (MRI). MRI does not use ionizing radiation and can provide three dimensional images of the bone structure. Figure 1 illustrates different imaging modalities, such as radiographs, DXA, and MRI, used to obtain images of the calcaneus and the proximal femur.
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Figure 1 – Images of calcaneus using (A) radiograph and (B) MR. Image of the proximal femur using (C) DXA and (D) MR.