Weight bearing exercise and increased dietary calcium intake have a synergistic effect on bone mass accrual at the femur in pre- and early pubescent girls

Abstract

There is evidence that quantitative ultrasound (QUS) at the proximal femur involves waves propagating circumferentially in the cortical shell. These waves, in theory, convey information on bone geometrical and material characteristics and thus have the potential to improve fracture risk prediction. In this work, the time-of-flight (TOF) of the first arriving signal (FAS) that corresponds to waves propagating circumferentially is considered. The relationships between the TOF of the FAS and geometrical features of the femoral neck are investigated. Five neck cross-sections from 11 human femurs from females (>65y) were extracted from 3-D X-ray quantitative computed tomography (XR-QCT) datasets. Geometrical parameters including cross-sectional area (CSA), minimum moment of inertia (Imin) and section modulus (Z) were computed from femoral neck cross-section images. Two-dimensional numerical simulation of US propagation through femoral neck was performed and TOF of the FAS was estimated. TOF was best correlated with Imin: R2=0.82 (p=10−4; RMSE=1390mm4 [13%]) in the region between proximal and mid-femoral neck and with Z: R2=0.55 (p<10−2; RMSE=480mm3 [17%]) and CSA: R2=0.62 (p<5.10−3; RMSE=22mm2 [7%]) in the mid-femoral neck. The results suggest that QUS has the potential to assess proximal femur strength based on estimates of geometrical properties of the cortical shell. (E-mail: [email protected])