Science & Evidence: Measuring Bone Mechanics
OsteoDx has developed Cortical Bone Mechanics Technology (CBMT), a radiation-free, noninvasive dynamic three-point bending test measuring flexural rigidity and damping in humans to characterize bone mechanical properties, quality, and strength. [R1-R5]
Bone mechanics, measured non-invasively.
Bone strength reflects more than mineral density. It emerges from geometry, material properties, cortical structure, and how bone behaves under load. CBMT was developed to evaluate that mechanical response at the ulna, adding a mechanics-based view of fracture-relevant bone quality that complements established assessment tools.
THE TECHNOLOGY BEHIND CBMT
The Science of Cortical Bone Mechanics
Cortical bone accounts for roughly 80% of adult skeletal bone mass and forms the dense outer structure of long bones. Its geometry and material behavior contribute importantly to bending, torsional, and compressive resistance. [R6–R9]
With aging, cortical thinning and increased cortical porosity can reduce mechanical integrity, particularly at appendicular skeletal sites. CBMT focuses on the mid-diaphyseal ulna, a cortical-dominant and accessible long-bone region suited for non-invasive bending assessment. [R2–R4, R8–R9]
MECHANICS-BASED MEASUREMENT
How CBMT™ Works
CBMT applies controlled, low-amplitude mechanical stimulation over the ulna and measures the resulting vibrational response. The frequency response is analyzed using a biomechanical model to estimate bending stiffness, flexural rigidity, and damping-related parameters. [R1–R4]
CBMT is designed to be:
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Non-invasive
Mechanical assessment through the skin, without needles, injections, or surgical procedures.
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Free of ionizing radiation
Uses controlled mechanical input and vibration sensing, not ionizing radiation.
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Low-force
Uses gentle mechanical input designed for repeatable testing.
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Designed for repeat assessment
Quantitative outputs support follow-up measurement in research and clinical-study settings.
The result is an objective, mechanics-based profile of cortical bone at the forearm.
Accurately Estimates Whole Bone Strength
Cadaveric data show that flexural rigidity is nearly perfectly correlated with whole bone breaking strength. [R4]
Why Mechanics Matter
Bone mineral density remains an important clinical measure, but density alone does not fully describe mechanical competence. Bone strength also depends on geometry, microarchitecture, tissue material behavior, porosity, and how the whole bone responds under loading. [R6–R9]
Population studies show that many fragility fractures occur in individuals whose areal BMD is not in the osteoporotic range. In the Rotterdam Study, most non-vertebral fractures occurred in people with normal or osteopenic areal BMD rather than osteoporosis. [R7]
CBMT evaluates bending-related mechanics at a cortical-rich appendicular site, providing a distinct, non-invasive measurement of mechanical bone quality. [R1–R4]
CLINICAL EVIDENCE
STRONGER Study: CBMT-derived mechanics
and fracture-case discrimination.
The STRONGER Study was a multicenter, case-control study of 372 postmenopausal women aged 50-80 years enrolled across four U.S. sites. The study compared CBMT-derived ulna flexural rigidity with DXA-derived areal BMD for distinguishing women with prior low-trauma fracture from matched controls. [R1, R3]
In the peer-reviewed STRONGER results, women with prior fracture had 21-22% lower CBMT-derived ulna flexural rigidity than controls. CBMT-derived ulna flexural rigidity demonstrated good fracture-case discrimination in the study cohort, with AUC 0.80 for weight-normalized EI and 0.76 for absolute EI. DXA-derived areal BMD at measured skeletal sites showed fair-to-poor discrimination in the same cohort, with AUCs <=0.63. [R1]
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Selected Peer-Reviewed Reference List