BoneGauge vs BoneCalc

BoneGauge allows you to approximate an individual's bone density and quality from a mobile platform. BoneGauge helps you make measurements of cortical thickness of the second metacarpal from either hand or wrist x-rays. Use your smart phone camera to take a photo of the second metacarpal on an x-ray, or make measurements from an image saved in your photo library. BoneGauge accurately calculates 2nd metacarpal cortical percentage (2MCP) in a semi-automated fashion. 2MCP has been shown to correlate with hip bone mineral density and T scores from DXA scans. Measurements made in the app will be uploaded to a central database. When combined with a patient's age, gender, and DXA score, past measurements will also help the improve the accuracy of future measurements. This app allows you to estimate an individual's global T score in an office or hospital setting, by simply taking a photo of the 2nd metacarpal. While this measurement may not completely replace DXA, it may help a clinician screen a patient's bone quality to assist in treatment decisions and determine who may benefit from further bone density testing or osteoporosis treatment.

The BoneCalc app is designed for the calculation of Z-scores and percentiles for bone mineral content (BMC) and areal bone mineral density (aBMD) for children under 20 years of age, as measured by dual-energy X-ray absorptiometry (DXA), for the following sites: whole-body subtotal (total-body-less-head), total hip, femoral neck, lumbar spine, distal ⅓ radius and ultradistal radius. Separate race-specific (Black and non-Black) and race-neutral calculations are available by age and sex. Height-Z–adjusted Z-scores for these measures are also calculated. The BMC and aBMD data are derived from the CHOP Bone Mineral Density in Childhood Study: race-specific for ages 5–20 [Zemel B et al., J Clin Endocrinol Metab 2011;96(10):3160–3169]; race-specific for ages 1–5 [Kalkwarf HJ et al., J Clin Endocrinol Metab 2022;107(9):e3887–e3900]; and race-neutral ages 5–20 [Zemel BS et al., J Clin Endocrinol Metab 2025;110(11):3034–3048]. Calculations are also available for lumbar-spine bone mineral apparent density (BMAD) for children 5–20 years of age: race-specific [Kindler JM et al. J Clin Endocrinol Metab 2019;104(4):1283–1292] and race-neutral [Zemel BS et al., J Clin Endocrinol Metab 2025;110(11):3034–3048].