Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2003 Oct;12 Suppl 2(Suppl 2):S90-6.
doi: 10.1007/s00586-003-0603-2. Epub 2003 Sep 12.

Overview of osteoporosis: pathophysiology and determinants of bone strength

Affiliations
Review

Overview of osteoporosis: pathophysiology and determinants of bone strength

Christopher M Bono et al. Eur Spine J. 2003 Oct.

Abstract

Recent advances in both the pharmacological and surgical treatment of osteoporosis and vertebral compression fractures offer exciting new options for elderly patients. However, these treatments should be considered only with an indepth knowledge of osteoporosis as a metabolic disorder with complex effects on bone, its homeostatic regulation, and vertebral strength. Bone homeostasis is under the influence of both endogenous hormonal changes and external mechanical loads resulting from physical activity. These impart their effects through regulation of the relative activities of bone cells, in particular osteoblasts and osteoclasts, which control bone deposition and resorption, respectively. The strength of a vertebra is directly influenced by the amount and relative proportions of its components, with bone mineral density a useful measure of fracture risk. The purpose of this article is to discuss these issues, among others, in order to offer the reader a better understanding of the pathophysiology of osteoporosis and the determinants of bone strength as they relate to the aging skeleton.

PubMed Disclaimer

Figures

Fig. 1a, b.
Fig. 1a, b.
Comparing close-up of views of normal and osteoporotic bone demonstrates a key pathological feature. Note the greater quantity of normal bone (a), as well as its greater interconnectivity, compared to osteoporotic bone (b)
Fig. 2.
Fig. 2.
The three basic types of stress that bone must endure are tension, compression, and shear. Tension is produced by forces acting in the same plane but away from each other. Compression is produced by forces acting in the same plane but towards each other. Shear is produced by two forces acting towards each other but in two different planes
Fig. 3.
Fig. 3.
Bone mineralization is initiated at sites known as holes and pores. Holes are located between the ends of juxtaposed collagen molecules. Pores are formed longitudinally between collagen molecules
Fig. 4.
Fig. 4.
The importance of interconnectivity of bone is shown by the analogy to a brick wall. Normal bone has interconnectivity, like the overlapping of the brick wall on the left. It can sustain heavy loads. Osteoporotic bone has lost its interconnectivity, like the brick wall on the right. Its walls can sustain only light loads, as they will collapse and buckle under heavier loads

Similar articles

Cited by

References

    1. Amling Orthopade. 2001;30:418. doi: 10.1007/s001320170072. - DOI - PubMed
    1. deLaet J Bone Miner Res. 2002;17:2231. - PubMed
    1. Eastell Proc Nutr Soc. 2002;61:173. doi: 10.1079/PNS2002160. - DOI - PubMed
    1. Einhorn Calcif Tissue Int. 1992;51:333. - PubMed
    1. Einhorn Spine. 2000;25:1051. - PubMed