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Remodeling of the calcaneus apophysis in the growing child.

Radiography and computer-aided analysis of tomography of the os calcis in 35 children with Sever's disease and of 52 control children were concurrently evaluated with histologic appearance of six calcanei of victims of road accidents, which were radiographically compatible with the same syndrome. Histology showed abrupt interruption in continuity of the apophysis of perpendicular fibrous plates with evidence of an ongoing reparative process. Computer-aided analysis of orientation of the "fragmentation" lines and histologic data both support the hypothesis of a stress remodeling process owing to excessive bending forces acting on the calcaneal apophysis.

Adolescent↗

Automatic detection of the boundary of the calcaneus from ultrasound parametric images using an active contour model; clinical assessment.

This paper presents a computerized method for automated detection of the boundary of the os calcis on in vivo ultrasound parametric images, using an active dynamic contour model. The initial contour, defined without user interaction, is an iso-contour extracted from the textural feature space. The contour is deformed through the action of internal and external forces, until stability is reached. The external forces, which characterize image features, are a combination of gray-level information and second-order textural features arising from local cooccurrence matrices. The broadband ultrasound attenuation (BUA) value is then averaged within the contour obtained. The method was applied to 381 clinical images. The contour was correctly detected in the great majority of the cases. For the short-term reproducibility study, the mean coefficient of variation was equal to 1.81% for BUA values and 4.95% for areas in the detected region. Women with osteoporosis had a lower BUA than age-matched controls (p = 0.0005). In healthy women, the age-related decline was -0.45 dB/MHz/yr. In the group of healthy post-menopausal women, years since menopause, weight and age were significant predictors of BUA. These results are comparable to those obtained when averaging BUA values in a small region of interest.

Adult↗

Comparison of measurements of phase velocity in human calcaneus to Biot theory.

Biot's theory for elastic propagation in porous media has previously been shown to be useful for modeling the dependence of phase velocity on porosity in bovine cancellous bone in vitro. In the present study, Biot's theory is applied to measurements of porosity-dependent phase velocity in 53 human calcanea in vitro. Porosity was measured using microcomputed tomography for some samples (n = 23) and estimated based on bone mineral densitometry for the remaining samples (n = 30). The phase velocity at 500 kHz was measured in a water tank using a through-transmission technique. Biot's theory performed well for the prediction of the dependence of sound speed on porosity. The trend was quasilinear, but both the theory and experiment show similar slight curvature. The root mean square error (RMSE) of predicted versus measured sound speed was 15.8 m/s.

Biomechanical Phenomena↗

The influence of cortical end-plate on broadband ultrasound attenuation measurements at the human calcaneus using scanning confocal ultrasound.

Quantitative ultrasound (QUS) assessment, including broadband ultrasound attenuation (BUA), is an efficient technique for assessing bone quality in various statuses, e.g., osteoporosis. While assessing trabecular bone loss is essential to bone quality, the existence of cortical bone can substantially reduce the accuracy of BUA measurement. In this study, we developed an approach to quantify the influence of the cortical end-plate in the QUS on 18 cadaver calcanei using both analytical and experimental analyses. A simplified cortical-trabecular-cortical sandwich model has been developed for simulation of wave propagations. Results show that the cortical end-plate has a significant effect on BUA (yielding 8.5 +/- 3.6 dB/MHz in cortical bone alone), approximately 15% of the BUA value over the whole bone BUA measurement (54.1 +/- 20.1 dB/MHz). The phenomenon has been predicted by the developed analytical model with a high correlation (r2 = 0.63, p < 0.0001). The data have suggested that the mechanism of the BUA attributed to the cortical end-plate is primarily due to the ultrasonic wave transmission and reflection within the cortical layers. Therefore, the influence of the cortical end-plate in BUA can be quantified and incorporated into the QUS assessment for bone quality, which may provide insight into BUA measurement for accurate diagnosis of bone diseases.

Bone Density↗

Anisotropy of ultrasonic backscatter and attenuation from human calcaneus: implications for relative roles of absorption and scattering in determining attenuation.

Although bone sonometry has been demonstrated to be useful in the diagnosis of osteoporosis, much remains to be learned about the processes governing the interactions between ultrasound and bone. In order to investigate these processes, ultrasonic attenuation and backscatter in two orientations were measured in 43 human calcaneal specimens in vitro at 500 kHz. In the mediolateral (ML) orientation, the ultrasound propagation direction is approximately perpendicular to the trabecular axes. In the anteroposterior (AP) orientation, a wide range of angles between the ultrasound propagation direction and trabecular axes is encountered. Average attenuation slope was 18% greater while average backscatter coefficient was 50% lower in the AP orientation compared with the ML orientation. Backscatter coefficient in both orientations approximately conformed to a cubic dependence on frequency, consistent with a previously reported model. These results support the idea that absorption is a greater component of attenuation than scattering in human calcaneal trabecular bone.

Anisotropy↗

Architectural modifications and cellular response during disuse-related bone loss in calcaneus of the sheep.

The results of simple biomechanical unloading in models of acute-disuse osteoporosis are influenced by systemic and regional effects of the method used to generate the bone loss. A model in which strain-gauge measurements confirmed that the os calcis was unloaded in healthy ewes during ambulation was assessed by histomorphometry. Twelve nonovariectomized adult female Welsh mountain sheep were submitted to hock joint immobilization by an external fixation procedure from the tibia to the metatarsus for a period of 12 wk. Histomorphometric analysis showed that this model was able to produce pure local bone loss, as transiliac bone biopsies failed to reveal any difference between the initial and final results. Immobilized and nonimmobilized calcanei were both removed postmortem. After the 12 wk of the study, osteoclastic activity was increased in accordance with the usual disuse process. An unexpected increase of osteoblastic activity was also observed, possibly related to recovery after the initial dramatic bone loss, but an artifact of the surgical procedure such as a regional acceleration phenomenon cannot be definitively excluded. However, the increased osteoblastic activity was not sufficient to prevent accentuation of the negative bone balance, resulting in a 29% decrease of trabecular bone volume in immobilized calcanei compared with nonimmobilized calcanei. This reduction was due to thinning of trabeculae (72.4 +/- 12.1 vs. 98.9 +/- 15.9 microns; P < 0.05) without any change in trabecular number (2.74 +/- 0.72 vs. 2.79 +/- 0.40/mm2; not significant). In conclusion, this model only locally increased both osteoclastic and osteoblastic activities leading to bone loss and architectural modifications. The decreased bone formation usually observed in other models of disuse osteoporosis may therefore not constitute a local phenomenon generated by unloading.

Animals↗