Determinants and assessment of bone strength

Abstract

Osteoporosis is a systemic skeletal disease characterised by low bone mass and micro-architectual deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone mineral density is a major component of bone strength and is predictive of future fracture risk. It is possible to measure BMD non-invasively at various skeletal sites using dual energy absorptiometry. Techniques such as quantitative ultrasound and magnetic resonance imaging also provide additional information on other facets of skeletal strength, although at present further research is required before they are incorporated into routine clinical practice. There is currently much interest in identifying factors involved in the determination of BMD and bone strength. Based on this knowledge, it may be possible to identify subjects who will have low BMD and will therefore be at risk of future fracture. Lifestyle interventions and drug treatments could therefore be targeted to "high risk" subjects to reduce the burden of osteoporotic fractures.