U.S. patent number 3,715,587 [Application Number 05/083,945] was granted by the patent office on 1973-02-06 for limb holder positioner for bone mineral analyzer.
Invention is credited to Robert Burkhalter, George L. Congdon.
United States Patent |
3,715,587 |
Burkhalter , et al. |
February 6, 1973 |
LIMB HOLDER POSITIONER FOR BONE MINERAL ANALYZER
Abstract
The disclosure relates to instruments for performing in vivo
analysis of bone mineral content by measuring the absorption of a
scanning beam of monoenergetic photons. Novel means are used for
supporting and positioning a limb so that a predetermined increment
of a bone therein can be scanned under repeatable conditions.
Scanning is done with a tissue equivalent material surrounding the
corresponding portion of the limb so that radiation transmission is
substantially uniform through the tissue regions of the scan but
has a sharp discontinuity where bone is in the beam.
Inventors: |
Burkhalter; Robert (Fort
Atkinson, WI), Congdon; George L. (Fort Atkinson, WI) |
Family
ID: |
22181673 |
Appl.
No.: |
05/083,945 |
Filed: |
October 26, 1970 |
Current U.S.
Class: |
378/195; 5/647;
250/492.1; 378/53; 378/156; 378/180; 607/88; 378/159; 378/189 |
Current CPC
Class: |
A61B
6/0421 (20130101); A61B 6/505 (20130101); G03B
15/14 (20130101) |
Current International
Class: |
A61B
6/00 (20060101); A61B 6/04 (20060101); G03B
15/14 (20060101); G03B 15/00 (20060101); G03b
041/16 () |
Field of
Search: |
;250/50,65R,86 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Lawrence; James W.
Assistant Examiner: Church; C. E.
Claims
We claim:
1. A bone mineral analyzer instrument to scan a portion of a human
limb over a predetermined scanning path, with a flexible casing
means covering the limb and filled with a fluid having
substantially equivalent radiation absorption characteristics as
body tissue to define an artificial surface simulating a
predetermined body tissue surface through which a bone increment
within said limb is scanned by a monitored radiation beam for
determining the mineral content of said bone increment as a
function of its radiation absorption, said instrument
comprising,
a support for said limb,
a closeable flexible casing means, a fluid filling said casing
means and having radiation absorption characteristics that are
substantially equivalent to the absorption characteristics of the
tissue, said casing means being sufficiently pliable with fluid
inside to be formed about said limb and deformed into a shape which
results in a predetermined tissue absorption characteristic being
presented to the beam in said scanning path,
a beam source means for establishing said radiation beam,
means to relatively move the source means and the support to scan
the limb, and
clamping means including a beam transmissive member to squeeze said
flexible casing means against said limb in the area being
scanned.
2. A device according to claim 1, wherein said casing means
comprises two fluid filled end portions connected by an
intermediate portion.
3. A device according to claim 2, in which said fluid material is
substantially pure water.
4. A device according to claim 1, in which said clamping means
includes
a base means having a beam transmissive window, and
clamp support means for supporting said clamping member parallel to
said base means and in alignment with said beam transmissive window
for adjustable movement toward and away from said base.
5. A device according to claim 4, including means for removably
attaching said base means to said instrument with said clamping
member and said beam transmissive window in alignment with the
scanning path of said beam.
6. A device according to claim 4, in which said clamp support means
is adapted for being positioned out of alignment with said beam
transmissive window.
7. A device according to claim 5, in which said base means
comprises a horizontal portion provided with said beam transmissive
window and a vertical portion extending upwardly from said
horizontal portion, said clamp support means including
a vertical post supported by said horizontal portion of said base
means,
means providing said vertical portion of said base means with a
vertical slot,
means slidably supporting said clamping member to said post with
the opposite end of said clamping member receivably in said slot to
thereby align with said clamping member with the scanning path of
said radiation beam, and
locking means for securing said clamping member to said post at any
selected vertical position of said clamping member.
8. A bone mineral analyzer instrument according to claim 1 further
comprising,
an abutment member adapted to abut with a predetermined extremity
surface of said portion of said limb when the latter is located in
transverse alignment with said scanning path,
adjustment means attaching said abutment member to said instrument
for adjustable movement relative to said scanning path, and
indicia means for identifying different adjusted positions of said
abutment member to enable that member to be adjusted repeatedly to
any position so identified.
9. A device according to claim 8, in which said abutment member is
adapted to be received between two outstretched fingers of the hand
of a forearm located in transverse alignment with said scanning
path.
10. A device according to claim 8, including
a bracket member supported with respect to said instrument for
adjustable movement in generally parallel relation to a limb
located in scanning position on said instrument,
means supporting said abutment member in fixed relation to said
bracket member, and
means defining a plurality of predetermined adjustment positions of
said bracket member along its path of adjustment movement.
Description
BACKGROUND OF THE INVENTION
The invention relates to instruments for performing in vivo
analysis of bone mineral content by measuring the absorption of a
scanning beam of monoenergetic photons and more particularly to
novel means for supporting and positioning a limb so that a
predetermined increment of a bone therein can be scanned through
tissue and intervening tissue equivalent material, the latter of
which is caused to surround the limb in such manner that radiation
absorption will be substantially uniform everywhere but through the
bone being analyzed.
The determination of total bone mineral content in humans can be of
considerable assistance in the diagnosis of certain diseases. In
the past, accurate measurements of bone mineral content required
the excision, ashing, and weighing of a bone sample, which
obviously cannot be employed as a method of routine or continuous
diagnostic procedure. Recently, however, accurate and convenient in
vivo determination of bone mineral content has been made possible
by the development of the so-called "Cameron Technique" in which a
collimated beam of monoenergetic radiation such as gamma rays from
a radioisotope is scanned across a limb and the unabsorbed
radiation is detected. The detector is associated with an
appropriate electronic system which records the resulting
absorption curve. The limb, usually the forearm, has heretofore
been submerged in a tissue equivalent material, such as water,
which has parallel upper and lower surfaces and about the same
absorption as tissue so that uniform absorption is obtained except
where bone is traversed by the scanning beam. Accordingly,
variations in the radiation absorption are functionally related to
the mineral content of the bone intercepting the beam. As described
more fully in copending U. S. patent application of Frederick A.
Rose, Ser. No. 83,944, filed Oct. 26, 1970, and entitled Bone
Mineral Analyzer, and which is assigned to the same assignee as
this invention, substantially automatic means can be provided to
control the scanning operation and to provide a direct digital
readout of the size and mineral content of the scanned bone
increment.
SUMMARY OF THE INVENTION
To eliminate the need for submerging or surrounding the forearm or
other limb in a liquid or putty-like tissue equivalent material,
which is obviously a rather inconvenient and messy process, the
present invention provides a scanning device of the type previously
described with a limb holder comprising a flexible casing or bag
permanently filled with a tissue equivalent fluid and adapted to
surround the portion of the limb being scanned. The bag is
preferably made of low absorption material as is the case with many
plastics. The bag is squeezed from opposite sides of the limb
between parallel support members that are transmissive of the
scanning beam, thus providing the required parallel surfaces and
uniform radiation absorption by the real and simulated body tissue
and also serving to immobilize the limb during the scanning
operation. Additionally, the limb holding device also includes a
novel adjustable means for positioning a predetermined bone
increment in alignment with the scanning means so that measurements
of the mineral content of that particular bone increment can be
made at other times under repeatable conditions.
BRIEF DESCRIPTION OF THE DRAWINGS
The drawings furnished herewith illustrate the best mode presently
contemplated by the inventors and clearly disclose the above
advantages and features as well as others which will be readily
understood from the detailed description thereof.
In the drawings:
FIG. 1 is a perspective view of a bone scanning instrument provided
with a limb holder and positioner according to a preferred
embodiment of the present invention;
FIG. 2 is a schematic cross sectional end view illustrating the
principle of operation of the instrument shown in FIG. 1;
FIG. 3 is a perspective view of the limb holder shown in FIG. 1
with the flexible tissue simulating bag removed;
FIG. 4 is a perspective view of the flexible tissue simulating bag
illustrated in FIG. 1;
FIG. 5 is a fragmentary plan view of the limb positioning device
illustrated in FIG. 1; and
FIG. 6 is a fragmentary front elevational view of the limb
positioner structure illustrated in FIG. 5.
DESCRIPTION OF THE PREFERRED ILLUSTRATED EMBODIMENT
As best illustrated in FIGS. 1 and 2, the illustrated bone scanning
instrument comprises a base housing 10 provided with a flat cover
member or table 11. A movable column 12 is supported with respect
to housing 10 by a slide connected to a drive mechanism, not shown,
adapted to move the column between a rearward position depicted in
solid lines in FIGS. 1 and 2, and a forward position shown in
broken lines in the latter figure.
The limb holder 13 comprises a support plate 14 removably attached
to table 11 by thumb screws 15 and is provided with a beam
transmissive window 16 positioned directly above a similar window
17 in the table. A suitable source of penetrating electromagnetic
radiation such as from a radioisotope in container 18 is supported
by the lower portion of column 12. Isotope container 18 emits a
monoenergetic beam of gamma rays upwardly through the superimposed
beam transmissive windows as the movement of the column carries the
isotope container along a path aligned with those windows. The beam
transmissive windows 16 and 17 can simply be openings in the metal
table 11 and the support plate 13 but it is preferable to provide
such openings with plastic window inserts that are opaque to
ordinary light but substantially transparent to gamma
radiation.
The head portion 19 of movable column 12 is provided with a
radiation detector 21 aligned with a collimator tube 22 positioned
directly above the radioisotope container 18 so that the detector
senses the intensity of a small vertical radiation beam emitted
upwardly through the beam transmissive windows 16 and 17 and the
other intervening elements. Accordingly, when a human forearm 23 is
located in the scanning path of the radiation beam as shown in
FIGS. 1 and 2, the response of the detector 21 varies as a function
of the absorption of the radiation beam, which is automatically
translated into a numerical indication of bone size and mineral
content by an electronic computer means, not shown, which are
described in detail in the previously identified commonly assigned
patent application.
In order that the detected beam intensity will not vary because the
beam passes through different thicknesses of body tissue, a body
tissue equivalent material is adapted to surround the body tissue
to simulate a limb having parallel surfaces though which the
scanning beam passes. In accordance with the present invention,
this objective is accomplished by means of a flexible casing in the
form of a plastic or rubber bag or bladder 24, shown in FIGS. 1, 2
and 4, which is filled with water or some other fluid having
substantially the same radiation absorbing characteristics as human
body tissue. Bag 24 preferably comprises two end sections 25 and 26
joined by an intermediate section 27. When the forearm is
positioned as shown in FIG. 1, the two end sections 25 and 26 of
the liquid filled bag are located above and below the portion of
the arm in the path of the scanning beam. The intermediate section
27 of the flexible casing is not imperative as the casing could be
variously shaped such as with a uniform cross section since it is
compressed to the desired shape anyway.
A clamping member 28 is adjustably carried by a post 29 extending
upwardly from support plate 14 and can be raised and turned aside
as shown in broken lines in FIG. 3 to allow the flexible bag 24 and
the forearm 23 to be located in scanning position. The clamping
member is then moved to the position shown in solid lines in FIG. 3
and is temporarily held in that position by a spring loaded detent
ball, not shown, which engages the flat surface 30 of post 29.
Accordingly, the clamping member 28 is aligned with the path of the
scanning beam and with vertical slot 31 in the support plate 13.
Thereupon, the clamping member is pressed firmly downwardly and is
locked in place by means of locking screw 32, thereby compressing
the end portions of the bag against the forearm and substantially
immobilizing the latter against accidental movement during the
scanning operation. Member 28 is made of plastic or other material
capable of transmitting gamma radiation and is of substantially
uniform thickness in a vertical direction along the portion thereof
located in the path of the scanning beam. Consequently, as
illustrated schematically in FIG. 2, the movement of column 12
causes the radiation beam to scan the forearm bones 33 through a
constant quantity of clamping member 28 material and through the
parallel surfaces 34 and 35 of the simulated parallel faced forearm
profile provided by the tissue equivalent fluid 36 in bag 24 and by
the body tissue 37 of the forearm. If the radiation absorption
characteristics of the clamping member 28 are equivalent to those
of the body tissue, it will be apparent that the clamping member
need not be of uniform thickness as long as its upper surface is
parallel to the horizontal surface of support plate 14.
If meaningful diagnostic information is to be obtained, it is often
necessary to monitor the bone mineral content of a patient
repeatedly over a considerable period of time. Since the size and
profile of the bone under investigation varies along the length of
that bone, the accuracy of such repetitive monitoring depends on
the ability to repetitively scan the same bone increment, which is
initially selected in accordance with the size and skeletal
characteristics of the particular patient.
To facilitate repetitive scanning of the same increment of bone as
tests are made from time to time, the present invention provides
the scanning instrument with a limb positioning device, best shown
in FIGS. 1, 5 and 6, which enables repeatable location of the limb.
The device comprises adjustable bracket member 41 provided with a
horizontal tongue 42 supporting a vertical abutment ear 43. The
index bar 39 is fixed to the edge of the top surface of table or
cover member 11 and includes a series of spaced indexing holes 44
associated with a series of reference indicia 45. Bracket member 41
includes a horizontal top portion 46 attached to tongue 42 and a
vertical portion 47 positioned adjacent the depending vertical lip
48 along the front edge of housing cover member 11. Behind lip 48
is a free space where the lip overhangs housing 11.
As shown in FIGS. 1, 2 and 6, a screw 49 screws endwise into a
spacer 52 on which there is a disc flange 53. Screw 49 holds spacer
52 against the back of the vertical portion of the bracket member
41 adjacent the lower edge of lip 48 so that flange 53 projects
behind the lip. A similar flange 54 is likewise supported on a
spacer 56 to the bracket by screw 55. The flange 54 projects behind
lip 48 but with its spacer 56 spaced from the lower edge of the
cover member lip 48. An index pin 58 projects downwardly from the
horizontal portion of the bracket member above the disc flange 54
and is selectively registered in an index hole 44 in the index bar
39. The reference numeral visible through bracket member hole 59
when pin 58 is registered may be recorded as the position of
abutment ear 43 between the patient's fingers. Because of the
clearance between flange 54 and the edge of table lip 48, the
bracket member 41 can be tilted to retract the index pin 58 from
the index bar 39, thus permitting the abutment ear 43 to be
adjusted toward or away from the beam scanning path to different
predetermined positions identified by indicia 45.
The patient's forearm is positioned with the abutment ear 43
received all the way between the ring and middle fingers and the
bracket member is adjusted to locate the desired bone increment in
alignment with the scanning path before the arm is immobilized by
means of the limb holder. Accordingly, the indicium visible through
the bracket hole 59 when the limb positioning device is properly
adjusted allows that adjustment to be noted and repeated so that
the same bone increment of that particular patient can be scanned
during subsequent examinations. If desired, the upper arm or lower
leg can also be scanned in the same manner, in which case the elbow
or heel is engaged by the abutment ear 43 of the positioning device
to allow repeatable measurements of the mineral content of the same
bone increment.
Various modes of carrying out the invention are contemplated as
being within the scope of the following claims particularly
pointing out and distinctly claiming the subject matter which is
regarded as the invention.
* * * * *