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As osteoporosis progresses, bone is lost and
consequently becomes weaker and more likely to fracture. This loss
is fastest in the trabecular bone, whose honeycomb structure provides
a lightweight scaffolding that transports loads efficiently through
the bone. Figure 1 shows a cross section of a typical femur showing
the cortical bone on the outside and the trabecular bone in the
middle .
This study used the profiles generated from the
fast Fourier transform (FFT) in five regions of the proximal femur.
Three profiles were tested for each region, a circular profile encompassing
all angles and profiles parallel and perpendicular to the preferred
orientation of the trabecular structure. This study compared a statistical
analysis of the profiles, using principal components analysis (PCA)
with fractal analysis and examined the performance of each method
in discriminating between fracture and control subjects.
Overall the perpendicular and circular profiles
were significantly better than the parallel profiles (P < 0.05)
and the PCA method performed significantly better than the fractal
analysis. There was no significant difference in the performance
of the region used, however the top 4 results all came from regions
located on the principal compressive trabeculae system (area under
the receiver operator curve = 0.74 – 0.93). These results
were uncorrelated with femoral neck bone mineral density, age or
body mass index, indicating that they may provide additional information
over these risk factors.
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Figure 1
Illustration of a cross-section of the femur, showing the cortical
and trabecular bone.
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