Estimating human long bone cross-sectional geometric properties: A comparison of noninvasive methods

Cross-sectional properties (areas, second moments of area) have been used extensively for reconstructing the mechanical loading history of long bone shafts. In the absence of a fortuitous break or available computed tomography (CT) facilities, the endosteal and/or periosteal boundaries of a bone may be approximated using alternative noninvasive methods. The present study tests whether cross-sectional geometric properties of human lower limb bones can be adequately estimated using two such techniques: the ellipse model method (EMM), which uses biplanar radiography alone, and the latex cast method (LCM), which involves molding of the subperiosteal contour in combination with biplanar radiography to estimate the contour of the medullary canal. Results of both methods are compared with "true" cross-sectional properties calculated by direct sectioning. The study sample includes matched femora and tibiae of 50 Pecos Pueblo Amerindians. Bone areas and second moments of area were calculated for the midshaft femur and tibia and proximal femoral diaphysis in each individual. Percent differences between methods were derived to evaluate directional (systematic) and absolute (random) error. Multiple regression was also used to investigate the sources of error associated with each method. The results indicate that while the LCM shows generally good correspondence to the true cross-sectional properties, the EMM generally overestimates true parameters. Regression equations are provided to correct this overestimation, and, when applied to another sample, are shown to significantly improve estimates for the femoral midshaft, although corrections are less successful for the other section locations. Our results suggest that the LCM is an adequate substitute for estimating cross-sectional properties when direct sectioning and CT are not feasible. The EMM is a reasonable alternative, although the bias inherent in the method should be corrected if possible, especially when the results of the study are to be compared with data collected using different methods.