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Abstract
<p class="first" id="P2">Fragility fractures are a growing problem worldwide, and
current methods for diagnosing
osteoporosis do not always identify individuals who require treatment to prevent a
fracture and may misidentify those not a risk. Traditionally, fracture risk is assessed
using dual-energy X-ray absorptiometry, which provides measurements of areal bone
mineral density (BMD) at sites prone to fracture. Recent advances in imaging show
promise in adding new information that could improve the prediction of fracture risk
in the clinic. As reviewed herein, advances in quantitative computed tomography (QCT)
predict hip and vertebral body strength; high resolution HR-peripheral QCT (HR-pQCT)
and micro-magnetic resonance imaging (μMRI) assess the micro-architecture of trabecular
bone; quantitative ultrasound (QUS) measures the modulus or tissue stiffness of cortical
bone; and quantitative ultra-short echo time MRI methods quantify the concentrations
of bound water and pore water in cortical bone, which reflect a variety of mechanical
properties of bone. Each of these technologies provides unique characteristics of
bone and may improve fracture risk diagnoses and reduce prevalence of fractures by
helping to guide treatment decisions.
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