The use of ultrasound transmission measurements for the assessment of properties of bone in normal and diseased states

Petley, Graham William (1994) The use of ultrasound transmission measurements for the assessment of properties of bone in normal and diseased states. University of Southampton, Doctoral Thesis.

Abstract

Osteoporosis claims many victims each year, causing pain and loss of life to many of those it affects. It also consumes a significant proportion of the resources of an already overstretched health service. Currently, treatments for the condition are limited and effective prophylaxis relies upon its early identification using techniques that are costly, relatively immobile and use ionizing radiation. More importantly these techniques measure only one of the factors contributing to increased bone fragility, namely bone mass.

Recently, ultrasound in the form of Broadband Ultrasonic Attenuation (BUA) has been used to assess the predominantly trabecula bone in the calcaneum, a technique shown in this thesis to be influenced in part by structure. However, there are a number of features of the approach that are less than ideal. In particular, at the outset of this study, the reproducibility was so poor compared with that available from ionising radiation techniques that it was not generally considered to be a useful clinical tool either for the early detection of disease by way of screening or for the assessment of its severity.

This thesis describes work carried out to investigate ways in which the clinical value may be improved. In particular attention is given to measurement accuracy, reproducibility and the identification of a feature within the calcaneum that could form the basis of measurement allowing meaningful comparisons to be made between individuals and larger populations. This has been accomplished with the use of a scanning system incorporating a small aperture receiver.

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