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Previous Volume 354:2250-2261 May 25, 2006 Number 21 Next

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Progress in understanding the pathogenesis of bone fragility is hampered by the inaccessibility of bone for investigation. Bone densitometry is an effective, noninvasive, and quantitative method for the assessment of the risk of fracture, but structures such as the vertebral body are depicted as a two-dimensional image — the areal bone mineral density cast by the attenuation of photons by mineral during their passage through bone. Just as the shadow of the earth, cast on the moon, reveals nothing of the topology of the earth's mountain ranges, the densitometric image tells us little about the two properties that determine bone . . . [Full Text of this Article]

Fabric and Structure of Bone — Levers and Springs

Composition of Bone

Microstructure and Macrostructure of Bone

Lever Action of Long Bones

Spring Action of Vertebral Bodies

Modeling and Remodeling of Bone

Negative Balance in the Bone Multicellular Unit

Trabecular Thinning and Loss of Connectivity

Cortical Thinning and Porosity

Periosteal Apposition

Bone Fragility in Patients with Fractures

Effects of Antiresorptive and Bone-Forming Agents

Conclusions

Source Information

From the Department of Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia (E.S.); and the Department of Rheumatology, Université Claude Bernard Lyon 1, and INSERM Research Unit 403 — both in Lyon, France (P.D.D.).

Address reprint requests to Dr. Seeman at the Department of Endocrinology, Austin Health, Heidelberg 3084, Melbourne, Australia, or at egos@unimelb.edu.au.

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