Design and Experimental Validation of an Automated System for Bone Fragility Assessment

Measurement accuracy and mechanical reliability are critical requirements in medical imaging and diagnostic systems, particularly in contexts where operator-dependent procedures and anatomical variability can affect outcomes. This thesis presents the design and experimental validation of an automated system for bone fragility assessment, developed to improve measurement consistency and user comfort in the execution of the Bone Elastic Structure Test (BES Test™). This work adopts a validation-driven engineering approach, integrating anthropometric analysis, experimental mechanics, and system-level testing. A mechanical characterization of 3D-printed polymeric specimens supports material selection in the design of structural components and phantom hands, while anthropometric modeling defines the geometric constraints for automated positioning and hand support design. Building on these foundations, a prototype device, OTTO, is developed, integrating mechanical actuation for automated positioning of the sensor and X-ray source, custom control software, and a graphical user interface. The system is designed to perform the BES Test™ acquisition workflow in a standardized and operator-independent manner. Validation is carried out through a structured experimental protocol, including repeatability and reproducibility analyses on anatomically realistic phantom hands, as well as usability testing on voluntary subjects. Quantitative results demonstrate accurate centering, repeatability metrics consistent with design requirements, and coherent correspondence with standard BES Test™ measurements. Overall, the results demonstrate the feasibility of a low-cost, automated, and mechanically reliable acquisition system for bone fragility assessment, providing a validated basis for further technical development.