Ohio University researchers say a new radiation-free wrist test that measures how much a bone resists bending may be spotting fracture risk that routine bone-density scans simply do not catch. In a multicenter study of postmenopausal women, the device, called Cortical Bone Mechanics Technology, or CBMT, flagged past fragility fractures far more accurately than the standard DXA scan.
What the STRONGER Study Found
The multicenter case-control STRONGER study enrolled 372 postmenopausal women ages 50–80 across four U.S. academic centers and compared CBMT-derived ulna flexural rigidity with DXA-derived areal bone mineral density. Women with prior low-trauma fractures had roughly 21–22% lower ulna rigidity, and CBMT showed substantially higher discriminatory accuracy (AUC ≈ 0.80) compared with DXA (AUC ≤ 0.63). In multivariable models CBMT remained independently associated with fracture status while BMD did not, suggesting the test captures strength information DXA misses, according to the Journal of Bone and Mineral Research.
How the Test Measures Strength
CBMT performs a dynamic three-point bending test of the ulna and uses multifrequency vibration analysis to estimate flexural rigidity, a mechanical property that reflects both bone geometry and tissue material. Because it measures mechanical stiffness rather than mineral content, the test is radiation-free and noninvasive and can pick up changes in cortical bone that DXA does not capture. "Instead of just measuring how dense your bones are, we're measuring how strong that bone actually is," lead investigator Brian Clark said in a university statement, as reported by Ohio University.
From Lab to Clinic
The CBMT technology has been spun out to a startup and supported with NIH Small Business Innovation Research funding to help speed commercialization, while researchers continue refining the device for broader testing. OsteoDx, the company commercializing CBMT, and public records show the development effort has received multimillion-dollar NIH support. Early backers say a quick, radiation-free screening test could eventually be used in clinics or research centers if prospective validation confirms predictive value, according to SBIR.gov.
Limits and Next Steps
The STRONGER study focused on postmenopausal women and excluded vertebral fractures, and nearly one-third of participants had a prior fragility fracture. Authors and university spokespeople say more research is needed to test CBMT in broader populations, including men and people from diverse racial and ethnic backgrounds, and in prospective studies that measure future fracture risk. The trial was prospectively registered (NCT05721898), and the team is calling for larger, prospective validation before clinical adoption, according to ClinicalTrials.gov.
Why It Matters for Ohio Patients
If prospective studies confirm CBMT's promise, clinicians in Ohio and beyond could better identify people who were told their bone density was "normal" but who actually have weakened bone mechanics and elevated fracture risk. "Our goal is simple: we want to identify people at risk before they break a bone," Clark said, emphasizing prevention and the possibility of reducing suffering and healthcare costs if earlier detection becomes routine, as reported by Ohio University.
