Clinical Studies on Osteoporosis
Osteoporosis is, by definition, a reduction in bone mass with remaining bone of normal composition. The related loss in bone strength results in fractures with little or no abnormal force. Since a valid measurement of low bone mass or osteopenia was not widely available until recently, the diagnosis of osteoporosis was based on evidence of vertebral fractures, together with generalized osteopenia, based on the radiological assessment of spinal radiographs. A vertebral fracture causes partial or complete compression (anterior or mid-vertebral compression or loss in height of the full width of the vertebrae). In the absence of low bone mass, however, these vertebral deformities would not be considered osteoporotic fractures. A vertebral deformity without osteopenia may be attributed, for example, to an old traumatic fracture, to genetic anomaly or to such pathological bone disease as tumour. With aging, we observe an increasing incidence of mid-thoracic anterior wedge deformities without radiological evidence of osteopenia. These age related deformities are not considered by radiologists to be vertebral fractures and usually the radiographs are reported as normal or normal for age. The radiological assessment of osteopenia is subjective, however, and a quantitative measurement of bone mass is required to provide a more reliable estimate of the degree of osteopenia associated with vertebral deformities. In addition, the quantitative measurement of bone mass should detect significant osteopenia with increased risk of fracture in patients without vertebral deformity.
KeywordsBone Mass Vertebral Fracture Bone Strength Radiological Assessment Vertebral Deformity
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