The purpose of this study was to determine the minimum thickness of co
rtical bone required for the accurate measurement of cortical material
density by compated tomography (CT) and to establish normal reference
values, A phantom with several wall thicknesses of bone-like material
was constructed to simulate various cortical widths, The CT density a
t each level of thickness was measured on a GE 9800 CT scanner and on
the OsteoQuant, a special CT scanner optimized for the measurement of
bone in the extremities, The minimum width required to attain the corr
ect material density was determined for each scanner, Additionally, th
e material density and width of the cortex in the radius and/or femur
were measured by CT in 761 healthy subjects, ages 4-84 years, The mini
mum thickness necessary for an accurate density evaluation of the wall
s of the phantom by CT was 2-2.5 mm; below these thresholds the values
fell in a linear way relative to width, In humans, the material densi
ty of cortical bone in the appendicular skeleton was not influenced by
height or weight, and the values, were similar for all subjects, as l
ong as the cortical width was above 2-2.5 mm, Tile cortical width incr
eased with age up to 30 years and decreased from 50 years on, We concl
ude that the material density of cortical bone in the appendicular ske
leton can be measured accurately by CT if the thickness of the cortex
exceeds 22.5 mm.