Bone quality: what is it and how is it measured?

Abstract

Bone quality describes aspects of bone composition and structure that contribute to bone strength independently of bone mineral density. These include bone turnover, microarchitecture, mineralisation, microdamage and the composition of bone matrix and mineral. New techniques to assess these components of bone quality are being developed and should produce important insights into determinants of fracture risk in untreated and treated disease. RESUMO Qualidade Óssea: O Que Significa e Como Mensurá-la?A qualidade do osso compreende os aspectos da composição e estrutura óssea que contribuem para sua força, independentemente da densidade mineral óssea, as quais incluem: turnover ósseo, microarquitetura, mineralização, microdanos e a composição da matriz óssea e mineral. Novas técnicas para avaliar estes componentes da qualidade óssea têm sido desenvolvidas e devem proporcionar importantes avanços para determinação do risco de fraturas nas doenças tratadas e não tratadas. WHAT IS BONE QUALITY?B ONE STRENGTH IS DETERMINED by bone mass, geometry and quality. The latter includes several aspects of bone structure and composition, including bone turnover, microarchitecture, the degree and distribution of mineralisation, the extent of microdamage and its repair and, finally, the composition of bone matrix and mineral (figure 1). These components are largely interdependent, so that a primary abnormality in one will often lead to changes in others. In particular, bone turnover is a major determinant of other components of bone quality and hence its measurement in clinical practice is of key importance.The recent interest in bone quality has arisen from observations that the traditional measure of bone strength in clinical practice, namely bone densitometry, does not always reliably predict fracture risk (1). This has stimulated the search for other aspects of bone composition and structure that contribute to bone fragility. This review describes some disease states in which abnormal bone quality is associated with increased fracture risk, sometimes despite increased bone mineral density. Techniques for the measurement of bone quality will be discussed together with how these

Bone quality evaluation of experimental osteometabolic disease in Pantanal alligators (Caiman yacare) by High Resolution Computerized Microtomography (μCT)

“…Computerized microtomography is a modern laboratory methodology considered the gold standard examination for bone quality assessment (composition, resistance, and geometry) that also allows understanding etiopathology of diseases (Compston 2006, Vasilić et al 2009, Bouxsein et al 2010, Liu et al 2011, Ritman 2011, Syahrom et al 2011, Gregor et al 2012, Blok et al 2013, Cesar et al 2013, Paolillo 2013, Fernandes 2014, Paolillo et al 2014, Fuller et al 2015. Total porosity (Po (tot), %)of trabecular bone of groups G1, G2, G3, and G4 for Pantanal alligator (Caiman yacare) tibia.…”

“…The main structural and functional elements that influence these properties are bone remodeling, composition of the organic and inorganic matrix, mineral distribution, and microscopic injuries. These features are interdependent and increase the complexity of skeleton formation in animals (Compston 2006).…”

“…These systems for image capturing and processing replicate tridimensional configuration of organs through quantitative parameters to express and assess the main structural elements of bones (Compston 2006).…”

Fractures of the Proximal Tibia Associated with Longterm Use of Methotrexate: 3 Case Reports and a Review of Literature

“…The latter includes several aspects of bone structure and composition, including bone turnover, microarchitecture, the degree and distribution of mineralization, the extent of microdamage and its repair, and finally, the composition of bone matrix and mineral 24 . BMD measurement does not show all these components.…”

Um estudo do método de homogeneização assimptótica visando aplicações em estruturas ósseas

“…A qualidade óssea compreende os aspectos da estrutura e composição óssea que contribuem para a rigidez e resistência do osso e são independentes da densidade mineral óssea, tais como turnover ósseo, microarquitetura, mineralização, microdanos e composição da matriz óssea e mineral. A resistência mecânica óssea é determinada pela qualidade óssea que envolve a massa óssea, a microestrutura (geometria, placas ou bastonetes no ossso trabecular e dimensões no osso cortical) e a orientação 3D (COMPSTON, 2006).…”