The Physical Measurement of Bone

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ISBN: 9780750308380 | 0750308389
Cover: Hardcover
Copyright: 12/1/2003

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There are a wide variety of methods applied in the physical analysis of bone in vivo and in vitro. Each method has its own uses and strengths depending on the information sought by the clinician or researcher. This book provides a detailed description of all the major methods of bone analysis, aimed at medical physicists and not clinicians, it details the physics of the processes and techniques employed in obtaining the measurements, with brief comments on clinical evaluation.It will appeal to practising medical physicists who need to know about the many methods of analysis open to them, and more importantly the wide coverage will provide a good introductory text to students of medical physics and biomedical engineering.

LIST OF CONTRIBUTORS

xxiii

PREFACE

xxvi

SECTION 1 INTRODUCTION

(122)

1. ANATOMY, PHYSIOLOGY AND DISEASE

(32)

1.1. Introduction

(2)

1.2. Bone morphology and organization

(1)

1.3. Bone tissue I: the role of bone cells

(5)

1.3.1. The osteoclast

(3)

1.3.2. The osteoblast

(1)

1.3.3. The osteocytes

(1)

1.4. Bone tissue II: the bony matrix

(3)

1.5. Bone composition: mineralization of bone matrix

(2)

1.6. Metabolic disorders of bone

(2)

1.6.1. Introduction

(2)

1.7. Osteoporosis

(8)

1.7.1. Introduction

(1)

1.7.2. Pathophysiology of osteoporosis

(2)

1.7.3. Etiologic factors in osteoporosis

(2)

1.7.4. Epidemiology

(3)

1.8. Summary

(1)

References

(9)

2. BIOLOGICAL SAFETY CONSIDERATIONS

(37)

2.1. Introduction

(1)

2.2. Duties and responsibilities

(2)

2.3. Environmental protection

(1)

2.4. Risk assessment

(1)

2.5. Quantifying risk

(1)

2.6. Acceptable risk

(1)

2.7. Risk reduction

(1)

2.8. Hierarchy of risk reduction

(1)

2.9. Specific risks associated with the processing of bone

(1)

2.9.1. Hazard identification

(1)

2.10. Mechanical hazards

(4)

2.10.1. Sawing bone

(1)

2.10.2. Electrical hazards

(1)

2.10.3. Chemical hazards

(1)

2.11. Hazard identification

(4)

2.11.1. Toxicity hazard

(1)

2.11.2. Corrosive hazards

(1)

2.11.3. Exposure limits

(1)

2.11.4. Reactive hazards

(1)

2.11.5. Flammability hazards

(1)

2.12. Extinguishers

(1)

2.13. Risk reduction and control: chemicals

(2)

2.13.1. Fume cupboards

(1)

2.13.2. Biological hazards

(1)

2.14. Hazard categories of biological agents

(1)

2.15. Hazard identification and hazard reduction at source

(1)

2.15.1. For human bone

(1)

2.15.2. For animal bone

(1)

2.16. Prion diseases

(1)

2.17. Biological control measures

(7)

2.17.1. Allergens: control of exposure

(1)

2.17.2. Microbiological safety cabinets

(1)

2.17.3. Disinfectants

(1)

2.17.4. Disinfection of cryostats

(1)

2.17.5. Fumigation

(1)

2.17.6. Disinfection of mechanical testing equipment and machine tools

(1)

2.17.7. Autoclaves

(1)

2.17.8. Disposal of biological waste

(1)

2.17.9. Removal of equipment

(1)

2.18. Use of personal protective equipment

(1)

2.19. General managerial considerations

(2)

2.19.1. Restricted access and permits to work

(1)

2.19.2. Occupational health screening

(1)

2.19.3. Prophylactic treatment

(1)

2.20. Contents of a risk assessment

(3)

2.20.1. Conveying the information to personnel

(1)

2.20.2. Who should compile a risk assessment?

(1)

2.21. Transport, packaging and labelling of biological samples

(2)

2.22 Ionizing and non-ionizing radiation

(1)

2.22.1. Ultraviolet light sources and lasers

(1)

2.22.2. Genetic modification

(1)

References

(2)

3. RADIATION SAFETY CONSIDERATIONS

(19)

3.1. Introduction

(5)

3.1.1. Units of radiation measurement

(2)

3.1.2. Radiation detector

(2)

3.2. Radiation dose to the patient

(7)

3.2.1. Introduction

(1)

3.2.2. Patient doses from dual X-ray absorptiometry

(2)

3.2.3. Patient doses from fan beam DXA

(1)

3.2.4. Doses from vertebral morphometry using DXA

(1)

3.2.5. Paediatric doses from DXA

(1)

3.2.6. Patient doses from QCT

(2)

3.2.7. Patient dose from other techniques

(1)

3.3. Staff dose from DXA

(2)

3.4. Staff dose from other techniques

(1)

3.5. Reduction of occupational dose

(1)

3.6. Dose reduction techniques in DXA applications

(1)

3.7. Problems with measuring patient and staff dose from absorptiometric techniques

(1)

3.8. Conclusion

(1)

References

(3)

4. INSTRUMENT EVALUATION

(32)

4.1. Introduction

(1)

4.2. Measurement errors

(3)

4.2.1. Types of measurement error

(2)

4.3. Equipment validation

(9)

4.3.1. Precision

(5)

4.3.2. Accuracy

(2)

4.3.3. When are two measurements significantly different?

101

(2)

4.4. Statistical methods in equipment validation

103

(10)

4.4.1 Method-comparison studies

103

(1)

4.4.2. Bland and Altman plot

104

(4)

4.4.3. Regression analysis and correlations

108

(2)

4.4.4. Clinical evaluation of a new device

110

(3)

4.5. Quality assurance (QA)

113

(7)

4.5.1. Introduction

113

(2)

4.5.2. Tools for QA

115

(5)

References

120

(3)

SECTION 2 INVASIVE TECHNIQUES

123

(142)

5. MECHANICAL TESTING

125

(60)

5.1. Introduction

125

(11)

5.1.1. Bone

125

(2)

5.1.2. Bone structure

127

(2)

5.1.3. Why study the mechanical properties of bone?

129

(1)

5.1.4. Basic concepts in bone mechanics and definition of terms

130

(6)

5.2. Equipment and specimen consideration

136

(3)

5.2.1. Equipment

136

(1)

5.2.2. Specimen handling

137

(2)

5.3. Methods of measuring the mechanical properties of bone tissue

139

(14)

5.3.1. Uniaxial compressive test

139

(2)

5.3.2. Uniaxial tensile test

141

(3)

5.3.3. Bending test

144

(2)

5.3.4. Torsion test

146

(1)

5.3.5. Fatigue

147

(1)

5.3.6. Indentation/hardness tests

148

(1)

5.3.7. Ultrasound

149

(3)

5.3.8. Conclusion

152

(1)

5.4. Methods of measuring the mechanical properties of the trabeculae

153

(8)

5.4.1. Microhardness

154

(1)

5.4.2. Nano-indentation

154

(5)

5.4.3. Buckling

159

(1)

5.4.4. Ultrasound technique

159

(1)

5.4.5. Other techniques

159

(2)

5.4.6. Conclusions

161

(1)

5.5. Factors Influencing the Mechanical Properties of Bone

161

(5)

5.5.1. Specimen configuration

162

(1)

5.5.2. Specimen preservation

163

(1)

5.5.3. Bone hydration

163

(1)

5.5.4. Sterilization

163

(1)

5.5.5. Strain rate

164

(1)

5.5.6. Age and disease

165

(1)

5.5.7. Temperature

166

(1)

5.5.8. Miscellaneous

166

(1)

5.6. Mechanical properties of bone

166

(8)

5.6.1. Introduction

166

(1)

5.6.2. Mechanical properties of cancellous bone

167

(5)

5.6.3. Mechanical properties of cortical bone

172

(2)

References

174

(11)

6. HISTOMORPHOMETRY

185

(40)

6.1. Introduction

185

(1)

Section A: Microarchitecture using computerized and manual techniques

186

(21)

6.2. Trabecular architecture non-invasive, non-destructive

188

(1)

6.3. Trabecular architecture two-dimensional histology

189

(2)

6.4. The trabecular analysis system (TAS)

191

(10)

6.5. Trabecular architecture three-dimensional image

201

(13)

6.5.1. Serial section techniques

202

(2)

6.5.2. Thick slice technique

204

(3)

Section B: Microfracture and microcallus

207

(7)

Section C: Matrix remodelling

214

(6)

6.6. Computer-assisted histomorphometry

214

(5)

6.6.1. The OsteoMeasure system

214

(4)

6.6.2. Tetracycline labelling and staining of the calcification front

218

(1)

6.7. Acknowledgments

219

(1)

References

220

(5)

7. MICROSCOPY AND RELATED TECHNIQUES

225

(40)

7.1. Introduction

225

(3)

Section A: Molecular labelling

228

(11)

7.2. Radioisotope-labelling of bone-autoradiography

228

(2)

7.3. Cryomicrotomy, bone histology and Immunohistochemistry

230

(8)

7.3.1. Immunohistochemistry

230

(4)

7.3.2. Immunohistochemistry of the extracellular matrix

234

(2)

7.3.3. Immunohistochemistry and colloidal gold labelling

236

(1)

7.3.4. In situ hybridization

237

(1)

7.4. Laser confocal microscopy

238

(1)

Section B: Mineral microanalysis and morphology

239

(22)

7.5. Mineral density

240

(1)

7.5.1. Ashing and volume displacement

240

(1)

7.5.2. Density gradient fractionation of powdered bone

240

(1)

7.6. Mineral Microanalysis

241

(7)

7.6.1. Microradiography

241

(2)

7.6.2. Backscattered electron image analysis

243

(1)

7.6.3. Electron probe X-ray microanalysis (by specialist Dr Roger C Shore)

244

(4)

7.7. Mineral morphology

248

(13)

7.7.1. Scanning electron microscopy

248

(1)

7.7.2. High velocity impact ('slam') freezing

249

(8)

7.7.3. Atomic and chemical force microscopy (by specialist Prof. Jennifer Kirkham)

257

(4)

7.8 Acknowledgments

261

(1)

References

261

(4)

SECTION 3 IONIZING RADIATION TECHNIQUES

265

(112)

8. ABSORPTIOMETRIC MEASUREMENT

267

(41)

8.1. Introduction

267

(1)

Section A: Fundamental principles of radiation physics

267

(10)

8.2. Fundamentals of radiation physics

267

(5)

8.2.1. γ-rays

269

(1)

8.2.2. X-rays

270

(1)

8.2.3. Inverse square law

271

(1)

8.3. Interaction of X-rays and γ-rays with matter

272

(5)

8.3.1. Introduction

272

(2)

8.3.2. Interaction mechanism

274

(2)

8.3.3. Attenuation in tissue

276

(1)

Section B: Instrumentation and principles

277

(12)

8.4. Generation of X-ray

277

(4)

8.4.1. Introduction

277

(1)

8.4.2. X-ray spectrum

278

(1)

8.4.3. Factors affecting the X-ray spectrum

279

(2)

8.5. Physical principles of absorptiometry

281

(8)

8.5.1. Single energy (γ-ray or X-ray) absorptiometry

281

(2)

8.5.2. Dual energy absorptiometry

283

(3)

8.5.3. Implementation of DXA

286

(3)

Section C: Clinical applications

289

(15)

8.6. Sites measured

289

(8)

8.6.1. Lumbar spine

289

(2)

8.6.2. Lateral spine

291

(2)

8.6.3. Proximal femur

293

(1)

8.6.4. Peripheral sites

294

(1)

8.6.5. Total body and body composition

295

(1)

8.6.6. Vertebral morphometry

296

(1)

8.7. Radiation dose to the patient

297

(1)

8.8. Sources of in vivo measurement error

297

(5)

8.8.1. Accuracy

298

(1)

8.8.2. Precision

298

(2)

8.8.3. Other error sources

300

(2)

8.9. Quality assurance and quality control

302

(37)

8.9.1. Quality assurance

302

(1)

8.9.2. Cross calibration

302

(2)

References

304

(4)

9. QUANTITATIVE COMPUTED TOMOGRAPHY

308

(11)

9.1. Introduction

308

(2)

9.2. Single-slice spinal bone funeral density measurement

310

(1)

9.3. Physical signilicance of QCT measurements

311

(2)

9.4. Measurement of BMD using volumetric CT images of the spine and hip

313

(3)

References

316

(3)

10. PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY AND MICRO-COMPUTED TOMOGRAPHY

319

(1)

10.1. Introduction

319

(1)

10.2. Development of pQCT

319

(2)

10.3. pQCT machine description

321

(2)

10.4. Bone properties and variables measured by pQCT

323

(3)

10.5. pQCT accuracy and precision for bone mineral and bone geometry assessments

326

(1)

10.6. Clinical utility of pQCT

327

(1)

10.7. Use of pQCT in pre-clinical testing

328

(1)

10.8. Introduction to μCT

329

(2)

10.9. What can be measured with μCT?

331

(1)

10.10. Summary

332

(1)

References

333

(4)

11. RADIOGRAMMETRY

337

(1)

11.1. Overview

337

(1)

11.2. Introduction

337

(2)

Section A: Fundamental principles of radiogrammetry

339

(6)

11.3. Basic one-dimensional radiogrammetric measurements from two-dimensional planar images

339

(1)

11.4. The cortical index

340

(1)

11.5. Precision of basic one-dimensional radiogrammetry measurement

341

(1)

11.6. Extending radiogrammetry from one-dimensional to two-dimensional measurement

341

(1)

11.7. Conversion of two-dimensional radiogrammetric measurements to bone volume per area

342

(1)

11.8. Conversion of calculated bone volume to bone mineral density (BMD)

343

(1)

11.9. Extending radiogrammetry to two-dimensional areas and three-dimensional volumes from two-dimensional cross-sectional slices

344

(1)

11.10. Extending radiogrammetry from two-dimensional slice measurement to true three-dimensional

345

(1)

Section B: Limiting factors in radiogrammetry

345

(4)

11.11. Image sharpness and image geometry

345

(4)

Section C: The clinical application of radiogrammetry

349

(5)

11.12. Implementing a new radiogrammetry technique in a clinical setting

349

(1)

11.13. Choosing an appropriate target condition

349

(1)

11.14. Choosing the target bone

350

(1)

11.15. Choosing the modality

350

(1)

11.16. Establishing the image geometry

351

(1)

11.17. Choosing the means of measurement

352

(1)

11.18. The need for comparative reference

353

(1)

11.19. Measurement validity

353

(1)

11.20. Further research opportunities in radiogrammetry

353

(1)

References

354

(1)

12. IN VIVO NEUTRON ACTIVATION ANALYSIS AND PHOTON SCATTERING

355

(1)

12.1. Introduction

355

(1)

12.2. In vivo neutron activation analysis (IVNAA)

356

(7)

12.2.1. Delayed gamma techniques

357

(5)

12.2.2. Prompt gamma techniques

362

(1)

12.2.3. Clinical applications and conclusion

362

(1)

12.3. Photon scattering methodologies in measurement of bone density

363

(10)

12.3.1. Theory

365

(1)

12.3.2. Techniques

366

(7)

12.3.3. Conclusions

373

(1)

References

373

(4)

SECTION 4 NON-IONIZING TECHNIQUES

377

(1)

13. MAGNETIC RESONANCE IMAGING

379

(222)

13.1. Introduction

379

(2)

13.2. Quantitative magnetic resonance (QMR)

381

(5)

13.3. Imaging of trabecular bone structure

386

(18)

13.3.1. In vitro studies

388

(5)

13.3.2. Animal models

393

(2)

13.3.3. In vivo human studies

395

(9)

13.4. Conclusion

404

(1)

13.5. Acknowledgment

405

(1)

References

405

(7)

14. QUANTITATIVE ULTRASOUND

412

(1)

Section A: Fundamentals of ultrasound propagation

412

(10)

14.1. Terminology

412

(2)

14.1.1. Ultrasound

412

(1)

14.1.2. Pregnancy

412

(2)

14.2. Ultrasound propagagion through materials

414

(3)

14.2.1. Spring model propagation

414

(1)

14.2.2. Modes of wave propagation

414

(2)

14.2.3. Velocity of ultrasound waves

416

(1)

14.2.4. Propagation velocity dependence

416

(1)

14.2.5. Phase and group velocity

416

(1)

14.3. Amplitude, intensity and attenuation

417

(1)

14.3.1. Amplitude and intensity

417

(1)

14.3.2. Attenuation

417

(1)

14.3.3. Broadband ultrasound attenuation

417

(1)

14.4. Interface behaviour

418

(2)

14.4.1. Acoustic impedance

418

(1)

14.4.2. Normal incidence at a tissue interface

418

(1)

14.4.3. Non-normal incidence at a tissue interface

419

(1)

14.4.4. Coupling

420

(1)

14.5. Ultrasound wave formats

420

(2)

14.5.1. Continuous, tone-burst and pulsed waves

420

(1)

14.5.2. Bandwidth theorem

421

(1)

14.5.3. Frequency spectrum and Q factor

422

(1)

Section B: Instrumentation

422

(11)

14.6. The ultrasound transducer and beam profile

422

(3)

14.6.1. Piezoelectric effect and transducer

422

(1)

14.6.2. Transducer design

423

(1)

14.6.3. Beam profile

424

(1)

14.6.4. Focusing

425

(1)

14.7. Instrumentation

425

(8)

14.7.1 Pulse-echo technique

425

(2)

14.7.2. Transmission technique

427

(1)

14.7.3. Simple radio-frequency (RF) system

427

(2)

14.7.4. Integrated pulse-echo system

429

(2)

14.7.5. Rectilinear scanning

431

(2)

14.7.6. Backscattering analysis

433

(1)

Section C: Theoretical modelling

433

(1)

14.8. Biot theory

433

(1)

14.9. Schoenberg's theory

434

(1)

14.10 Other models

434

(1)

Section D: In vitro experiments

434

(14)

14.11. Bone samples

434

(1)

14.11.1. Source

434

(1)

14.11.2. Sample size and shape

434

(1)

14.11.3. Sample preparation

435

(1)

14.12. Measurement: methodology and analysis

435

(9)

14.12.1. Coupling

435

(1)

14.12.2. Transducers

436

(1)

14.12.3. Transit time velocity measurements

436

(1)

14.12.4. Alternative velocity measurements

437

(1)

14.12.5. Critical angle reflectometry

438

(1)

14.12.6. Attenuation

438

(1)

14.12.7. Error sources

438

(6)

14.13. In vitro experimental findings

444

(4)

14.13.1. QUS and bone density

444

(1)

14.13.2. QUS and mechanical properties

445

(1)

14.13.3. QUS and bone structure

446

(2)

Section E: In vivo clinical assessment

448

(16)

14.14. Commercial systems

448

(10)

14.14.1. Anatomical sites

448

(3)

14.14.2. Methodology: coupling

451

(1)

14.14.3. Methodology: measurement variables

452

(3)

14.14.4. Quality assurance

455

(1)

14.14.5. Cross-calibration

455

(2)

14.14.6. Artefacts and sources of errors

457

(1)

14.15. In vivo application of ultrasound

458

(17)

14.15.1. In vivo studies

458

(1)

14.15.2. In vivo QUS measurement

459

(1)

14.15.3. Age-related change

459

(1)

14.15.4. Velocity diagnostic sensitivity

460

(1)

14.15.5. BUA diagnostic sensitivity

461

(1)

14.15.6. QUS and longitudinal monitoring

462

(1)

14.15.7. Paediatric application

463

(1)

14.15.8. Application to rheumatoid arthritis

463

(1)

References

464

(11)

15 FINITE ELEMENT MODELLING

475

(1)

15.1. Introduction

475

(1)

Section A: Finite element analysis of bone: general considerations

475

(6)

15.2. Fundamentals of FE analysis

475

(1)

15.3. FE analysis applied to bone

476

(3)

15.3.1. Structural and solid mechanics FE analysis

476

(2)

15.3.2. Poroelastic FE analysis

478

(1)

15.3.3. Other types of FE analysis

478

(1)

15.4. Generation of FE models

479

(2)

15.5. Equipment and software

481

(1)

Section B: Bone mechanical characterization and fe modelling at different levels of structural organization

481

(7)

15.6. The whole bone (apparent) level

482

(3)

15.6.1. Structural characterization

482

(1)

15.6.2. Mechanical characterization

483

(1)

15.6.3. FE modelling

484

(1)

15.7. The trabecular bone level

485

(2)

15.7.1. Structural characterization

485

(1)

15.7.2. Mechanical characterization

485

(1)

15.7.3. FE modelling

485

(2)

15.8. Bone tissue and ultrastructural level

487

(1)

15.8.1. Structural characterization

487

(1)

15.8.2. Mechanical characterization

487

(1)

15.8.3. FE modelling

487

(1)

Section C: FE analysis of bone and bones at the organ level: contemporary applications and results

488

(8)

15.9. Analysis of bone mechanical properties and loading

488

(4)

15.9.1. Bone failure load

488

(1)

15.9.2. Bone fracture healing and tissue differentiation analysis

489

(1)

15.9.3. Consequences of orthopaedic implants and interventions

490

(2)

15.10. Clinical assessment of bone mechanical properties

492

(1)

15.11. Simulation of mechanically induced biological processes

492

(4)

15.11.1. Bone remodelling

493

(2)

15.11.2. Tissue differentiation and fracture healing

495

(1)

Section D: FE analysis at the bone trabecular level: recent applications and results

496

(7)

15.12. Analysis of bone mechanical properties and loading

496

(3)

15.12.1. Elastic properties

496

(1)

15.12.2. Strength and yield properties

497

(1)

15.12.3. Assessment of physiological bone tissue loading

498

(1)

15.13. Clinical assessment of bone mechanical properties

499

(1)

15.14. Simulation of mechanically induced biological processes

500

(2)

15.14.1. Bone remodelling

500

(2)

15.15. Summarizing conclusion

502

(1)

References

503

(8)

16 VIBRATION ANALYSIS

511

(1)

Section A: Introduction

511

(2)

16.1. Condition monitoring of machinery

511

(1)

16.2. Modal analysis

512

(1)

16.3. Non-destructive testing

512

(1)

16.3.1. Transverse (flexural) vibration methodology

512

(1)

16.4. Vibrational measurements applied to bone

513

(1)

Section B: Material properties of whole long bones

513

(17)

16.5. Frequency response measurements

513

(8)

16.5.1. Early studies

513

(2)

16.5.2. Impulse frequency response (IFR) technique

515

(1)

16.5.3. Bone resonance analysis (BRA) technique

516

(1)

16.5.4. Comparison of IFR and BRA techniques

517

(1)

16.5.5. Mechanical response tissue analysis (MRTA)

518

(2)

16.5.6. Effect of soft tissue on frequency

520

(1)

16.6. Longitudinal wave propagation

521

(3)

16.6.1. One-point method

522

(1)

16.6.2. Two-point method

523

(1)

16.7. Association of resonant frequency with torsional and bending stiffness

524

(1)

16.8. Use of vibration to monitor treatment effect

525

(1)

16.9. Vibration modelling studies

526

(4)

16.9.1. Ulnar model

526

(1)

16.9.2. Tibia model

527

(2)

16.9.3. Femur model

529

(1)

16.10. Summary

530

(1)

Section C: The use of vibration in the monitoring of fracture healing

530

(11)

16.11. Introduction

530

(1)

16.12. Low frequency wave propagation

531

(3)

16.12.1. Propagation and measurement of low frequency waves ('stress waves')

531

(1)

16.12.2. In vitro results

532

(1)

16.12.3. In vivo results

533

(1)

16.13. Resonant frequency measurement

534

(5)

16.13.1. Swept sinusoidal vibration

534

(1)

16.13.2. Impulse-response method

535

(4)

16.14. Modelling of the effect of healing

539

(1)

16.15. Other measurements

540

(1)

16.16. Summary

541

(1)

Section D: The use of vibration in the diagnosis of prosthesis loosening

541

(2)

16.17. Summary

543

(1)

References

543

(8)

17 HUMAN STUDIES

551

(1)

17.1. Introduction

551

(1)

Section A: Presentation of BMD

551

(5)

17.2. Units of measure

551

(2)

17.3. Reference population

553

(1)

17.4. T-scores

553

(1)

17.5. Z-scores

554

(2)

Section B: Interpretation of BMD Results

556

(3)

17.6. WHO criteria

556

(1)

17.7. Limitations of WHO criteria

556

(1)

17.8. NOF recommendations

557

(1)

17.9. Fracture risk assessment

558

(1)

Section C: Utility of BMD

559

(3)

17.10. Who should be tested?

559

(1)

17.11. How to apply BMD

560

(1)

17.12. Diagnostic algorithms

561

(1)

Section D: Which Site to Measure

562

(2)

17.13. Available sites

562

(1)

17.14. Limitations

563

(1)

17.15. Combining sites to increase diagnostic power

563

(1)

Section E: Treatment Considerations

564

(1)

Section F: Measurement errors

565

(2)

17.16. Conclusions

567

(1)

References

567

(4)

18 ANIMAL STUDIES

571

(1)

18.1. Introduction

571

(1)

18.2. Animals models

571

(4)

18.2.1. Introduction

571

(1)

18.2.2. Modelling osteoporosis in animals

572

(1)

18.2.3. Rat as a model for osteoporosis

573

(1)

18.2.4. Sheep as a model of osteoporosis

574

(1)

18.3. Bone status measurements

575

(1)

18.3.1. Introduction

575

(1)

18.3.2. Bone density

575

(1)

18.3.3. Bone structure

575

(1)

18.3.4. Bone biomechanical properties

576

(1)

18.4. Techniques for measuring bone density

576

(2)

18.4.1. Dual X-ray absorptiometry (DXA)

576

(1)

18.4.2. Peripheral dual X-ray absorptiometry

577

(1)

18.4.3. Peripheral quantitative computed tomography (pQCT)

578

(1)

18.5. Techniques for measuring bone structure

578

(13)

18.5.1. Introduction

578

(1)

18.5.2. Radiography, microradiography and radiogrammetry

579

(2)

18.5.3. Peripheral quantitative computed tomography (pQCT)

581

(1)

18.5.4. Micro-computed tomography (μCT)

582

(2)

18.5.5. Synchrotron radiation μCT

584

(1)

18.5.6. μCT three-dimensional assessment

585

(2)

18.5.7. Magnetic resonance imaging (MRJ) microscopy

587

(3)

18.5.8. Histomorphometry

590

(1)

18.6. Bone strength measurement

591

(1)

18.7. Summary and perspectives

592

(2)

References

594

(7)

INDEX

601

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