Bone mineralization density distribution in health and disease

Roschger, Paul; Paschalis, Eleftherios P.; Fratzl, Peter; Klaushofer, Klaus

doi:10.1016/j.bone.2007.10.021

Cited by 574 publications

(640 citation statements)

References 69 publications

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“…BMDD is a measure of the degree and heterogeneity of mineralization in bone tissue. (33)(34)(35) In the healthy adult population, BMDD of cancellous bone shows only minor variations with age, gender, ethnicity, and skeletal site, (36) indicating that the normal BMDD corresponds to a biologic and mechanical optimum. Therefore, even small deviations from the normal BMDD may have biologic meaning.…”

Section: Insights Into the Pathogenesis Of Atypical Femoral Fracturesmentioning

confidence: 99%

Atypical subtrochanteric and diaphyseal femoral fractures: Report of a task force of the american society for bone and mineral Research

Shane

Burr

Ebeling

et al. 2010

Journal of Bone and Mineral Research

986

679

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Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address key questions related to this problem. A multidisciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as preclinical studies that could provide insight into their pathogenesis. A case definition was developed so that subsequent studies report on the same condition. The task force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma, a medial spike when the fracture is complete, and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their association with cortical thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions, and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids, and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end products, mineralization, remodeling, vascularity, and angiogenesis lend biologic plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure, and there is concern that lack of awareness and underreporting may mask the true incidence of the problem. Given the relative rarity of atypical femoral fractures, the task force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance, and additional epidemiologic and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopedic and medical management. ß

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Section: Insights Into the Pathogenesis Of Atypical Femoral Fracturesmentioning

confidence: 99%

Atypical subtrochanteric and diaphyseal femoral fractures: Report of a task force of the american society for bone and mineral Research

Shane

Burr

Ebeling

et al. 2010

Journal of Bone and Mineral Research

986

679

View full text Add to dashboard Cite

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“…1,11,43,46 To date, it is unknown if age-related osteoporosis occurs in the horse and whether the equine DP would be affected given its different inherent architectural and functional properties as compared to a more typical long bone.…”

Section: Discussionmentioning

confidence: 99%

Osteopathology in the Equine Distal Phalanx Associated With the Development and Progression of Laminitis

et al. 2015

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Although the equine distal phalanx and hoof lamellae are biomechanically and physiologically integrated, bony changes in the distal phalanx are poorly described in laminitis. The aims of this study were (1) to establish a laminitis grading scheme that can be applied to the wide spectrum of lesions seen in naturally occurring cases and (2) to measure and describe changes in the distal phalanx associated with laminitis using micro-computed tomography (micro-CT) and histology. Thirty-six laminitic and normal feet from 15 performance and nonperformance horses were evaluated. A laminitis grading scheme based on radiographic, gross, histopathologic, and temporal parameters was developed. Laminitis severity grades generated by this scheme correlated well with clinical severity and coincided with decreased distal phalanx bone volume and density as measured by micro-CT. Laminitic hoof wall changes included progressive ventral rotation and distal displacement of the distal phalanx with increased thickness of the stratum internumcorium tissues with lamellar wedge formation. Histologically, there was epidermal lamellar necrosis with basement membrane separation and dysplastic regeneration, including acanthosis and hyperkeratosis, corresponding to the lamellar wedge. The changes detected by micro-CT corresponded to microscopic findings in the bone, including osteoclastic osteolysis of trabecular and osteonal bone with medullary inflammation and fibrosis. Bone changes were identified in horses with mild/early stages of laminitis as well as severe/chronic stages. The authors conclude that distal phalangeal pathology is a quantifiable and significant component of laminitis pathology and may have important implications for early detection or therapeutic intervention of equine laminitis.Keywords horse, laminitis, distal phalanx, pathology, diagnostic imaging, micro-computed tomography, x-ray microtomography, osteolysis, osteopathologyThe structural integrity of the highly specialized and complex elements composing the equine foot-including the epidermal and dermal lamellae, bone, tendons, ligaments, and other connective tissues-is essential for suspension of the distal phalanx (DP) within the hoof capsule. The interface between the equine DP and inner hoof wall is unique in that the dorsal cortex of the DP is highly porous relative to the solar cortex or to the cortices of other bones in the appendicular skeleton.39 These porosities correspond to perforating vascular channels that extend from the medullary spaces of the DP to supply the overlying lamellar tissues. 30,39 Thus, the unique interface of this specialized musculoskeletal unit provides a direct microanatomic integration between bone and epidermal/dermal lamellar tissues.Laminitis is a disease affecting the epidermal and dermal lamellae of the inner hoof wall, which often progresses to a chronic phase. The chronic phase of laminitis is characterized by inadequate tissue healing and aberrant regenerative responses that result in lamellar hyperplasia and dysplasia,...

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“…3 and Table 3). [115][116][117][118][119][120][121][122][123][124][125][126][127][128][129] The principles governing the mineralization of biological tissues, or those preventing it from mineralizing, have evolved over millions of years into robust mechanisms that function under a variety of environmental challenges. A detailed understanding of such principles is naturally inspiring new approaches in engineering.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

A materials science vision of extracellular matrix mineralization

et al. 2016

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From an engineering perspective, skeletal tissues are remarkable structures in that they are lightweight, stiff and tough, yet produced at ambient conditions. The biomechanical success of skeletal tissues is largely attributable to the process of biomineralization -a tightly regulated, cell-driven formation of billions of inorganic nanocrystals formed from ions found abundantly in body fluids. In this Review, we discuss nature's strategies to produce and sustain appropriate biomechanical properties in mineralizing (by promotion of mineralization) and nonmineralizing (by inhibition of mineralization) tissues. We review how perturbations of biomineralization are controlled over a continuum which spans from the desirable (or defective in disease) mineralization of the skeleton, to pathological cardiovascular mineralization, and to mineralization of bioengineered constructs. A materials science vision of mineralization is presented with an emphasis on the micro-and nanostructure of mineralized tissues recently revealed by state-of-the-art analytical methods, and on how biomineralization-inspired designs are impacting the field of synthetic materials. Web summaryComplex mechanisms are at play in the biomineralization of skeletal tissues and in patholological calcification in the cardiovascular system. In this Review, the physiochemical and biomechanical properties of mineralized tissues, both physiologic and pathophysiologic, and analytical methods to elucidate their finer structure are discussed.

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Bone mineralization density distribution in health and disease

Cited by 574 publications

References 69 publications

Atypical subtrochanteric and diaphyseal femoral fractures: Report of a task force of the american society for bone and mineral Research

Atypical subtrochanteric and diaphyseal femoral fractures: Report of a task force of the american society for bone and mineral Research

Osteopathology in the Equine Distal Phalanx Associated With the Development and Progression of Laminitis

A materials science vision of extracellular matrix mineralization

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