Table of Contents
1.
slide 1
2.
What is Bone?
3.
Bone Composition
4.
Bone as a Living Tissue
5.
Increase in Bone Mass with Age in Children
6.
Determinants of Peak Bone Mass
7.
Osteoclast
8.
Bone Remodeling Process
9.
slide 9
10.
Normal Bone Remodeling
11.
Normal bone remodeling
12.
High Bone Turnover Leads to Development of Stress Risers and Perforations
13.
slide 13
14.
Biochemical Markers of Bone Turnover Released During Remodeling Process
15.
? resorption or ? formation
16.
Major Factors that Influence Remodeling Balance
17.
10
18.
Blood Ca++
19.
Blood Ca++
20.
Mean calcium intake
21.
0
22.
Adapted from Meunier PJ, et al. Clin Ther. 1999;21:1025-1044
23.
+
24.
Relationship Between BMD and
25.
Correlates with life time fracture risk for Caucasian Women
26.
T= - 2 Z= - 0.5
27.
Utility of bone densitometry
28.
slide 28
29.
Relationship Between BMD and
30.
+
31.
Spine (vertebra)
32.
Relative Influence of Inner and Outer Diameters on Bone Strength
33.
Relevance of Architecture to Structural Strength
34.
THE BUCKLING LOAD OF A STRUT
35.
Cross-Bracing Improves Strength
36.
hip axis length
37.
Turner CH, et al. Bone. 1993;14:595-608
38.
Contributors to strength Trabecular thickness Trabecular number Connectivity Matrix quality/mineralization
39.
Excess resorption leads to trabecular thinning May also lead to trabecular perforation and loss of connectivity Loss of horizontal struts disproportionally reduces strength of cancellous bone (a 10% bone loss which interrupts connectivity reduces strength by 70%)1
40.
Changes in trabecular architecture with age
41.
Normal bone structure
42.
Adapted from Parfitt AM, Am J Med. 1987;82:68-72
43.
Adapted from National Osteoporosis Foundation, Physicianns Guide to Prevention and Treatment of Osteoporosis. Modified from Riggs BL and Melton LJ III. Osteoporosis: Etiology, Diagnosis, and Management. New York: Raven Press; 1988
44.
Adapted from National Osteoporosis Foundation, Physicianns Guide to Prevention and Treatment of Osteoporosis. Modified from Riggs BL and Melton LJ III. Osteoporosis: Etiology, Diagnosis, and Management. New York: Raven Press; 1988