The Bone Structure Index and the requirements for its evaluation with a hand-held x-ray imaging system

The social costs of osteoporosis are huge and keep growing because of increased life expectancy. Although a low bone mineral density is considered to be associated with a higher risk of fracture, densitometry alone has been shown to be inadequate to predict a significant number of fractures, hence the need to develop innovative and inexpensive diagnostic methods to be used together with the consolidated systems. The Bone Structure Index is computed using a patented technique that virtually simulates the application of compressive loads on the trabecular structure’s reconstructions obtained from the patient’s digital radiographs. The radiograms are acquired by a hand-held portable x-ray system equipped with a digital sensor. This configuration presents specific advantages but the use of a handheld portable X-ray device requires safety procedures specifically designed to protect the operator and the patient, which are discussed in the present paper.