Medical Imaging as a Bone Quality Determinant and Strength Indicator of the Femoral Neck - Biomedical Engineering Systems and Technologies - page 188

Medical Imaging as a Bone Quality Determinant
and Strength Indicator of the Femoral Neck

Alexander Tsouknidas 1,* , Nikolaos Michailidis 1 , and Kleovoulos Anagnostidis 2

1 Physical Metallurgy Laboratory, Mechanical Engineering Department,
Aristoteles University of Thessaloniki, Thessaloniki, Greece
[e-mail], [e-mail]
2 3rd Orthopaedic Department ”Papageorgiou” General Hospital,
Aristoteles University of Thessaloniki, Thessaloniki, Greece
[e-mail]

Abstract. Early diagnosis of osteoporosis is a key factor in preventive medi-
cine of this clinically silent bone pathology. The most severe manifestation of
osteoporotic bone loss is encountered in hip fractures and therfore, this study
represents an effort in associating bone quality of the femoral neck region to
fragility fracture risks through FEA supported imaging techniques. The con-
cepts of Magnetic resonance imaging (MRI), Computer Tomography (CT) and
Dual-energy X-ray absorptiometry (DXA) are introduced, along with their li-
mitations in defining bone quality and calculating the apparent bone strength.
As DXA dominates surgeons' preference in evaluating bone mineral density in
the hip region, in vivo measurements of this method, sustained by ex-vivo
uniaxial compression tests and FEA supported calculations are employed to
determine a fracture risk indicator of the femoral neck versus bone mineral
density (BMD).

Keywords: Medical imaging, Osteoporosis, Femoral neck, FEA, Fracture risk.

1 Introduction

Medical imaging has revolutionalized modern medicine, providing an accurate but
foremost non-invasive overview of the patient's condition. This fosters, preoperative
recognition of abnormalities or determination of the progression of pathogenesis like
osteoporosis.
Osteoporosis is a multifactorial bone disease concerning roughly 4% of the human
population [1]. Due to its high morbidity and global nature, osteoporosis is considered
a pathology with a significant socioeconomic impact [2]. As an asymptomatic condi-
tion, osteoporosis fails to exhibit noticeable symptoms, particularly at early stages and
thus is usually underdiagnosed. Untreated however, this clinically silent disease, is
likely to increase the risk of fragility fractures [3,4,5].
An osteoporotic patient's BMD is drastically reduced, deteriorating the bones'
micostructural characteristics as a result of excessive bone resorption followed by
* Corresponding author.