Document Detail

Diseases affecting bone quality: beyond osteoporosis.
MedLine Citation:
PMID:  21107923     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Bone quantity, quality, and turnover contribute to whole bone strength. Although bone mineral density, or bone quantity, is associated with increased fracture risk, less is known about bone quality. Various conditions, including disorders of mineral homeostasis, disorders in bone remodeling, collagen disorders, and drugs, affect bone quality.
QUESTIONS/PURPOSES: The objectives of this review are to (1) identify the conditions and diseases that could adversely affect bone quality besides osteoporosis, and (2) evaluate how these conditions influence bone quality.
METHODS: We searched PubMed using the keywords "causes" combined with "secondary osteoporosis" or "fragility fracture." After identifying 20 disorders/conditions, we subsequently searched each condition to evaluate its effect on bone quality.
RESULTS: Many disorders or conditions have an effect on bone metabolism, leading to fragility fractures. These disorders include abnormalities that disrupt mineral homeostasis, lead to an alteration of the mineralization process, and ultimately reduce bone strength. The balance between bone formation and resorption is also essential to prevent microdamage accumulation and maintain proper material and structural integrity of the bone. As a result, diseases that alter the bone turnover process lead to a reduction of bone strength. Because Type I collagen is the most abundant protein found in bone, defects in Type I collagen can result in alterations of material property, ultimately leading to fragility fractures. Additionally, some medications can adversely affect bone.
CONCLUSIONS: Recognizing these conditions and diseases and understanding their etiology and pathogenesis is crucial for patient care and maintaining overall bone health.
Aasis Unnanuntana; Brian J Rebolledo; M Michael Khair; Edward F DiCarlo; Joseph M Lane
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-06-30     Completed Date:  2011-09-30     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2194-206     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, Hospital for Special Surgery, and Weill Cornell Medical College, Cornell University, 535 East 70th Street, New York, NY 10021, USA.
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MeSH Terms
Antirheumatic Agents / therapeutic use
Bone Density*
Bone Diseases / metabolism,  physiopathology*
Bone Resorption / physiopathology
Bone and Bones / drug effects,  metabolism,  physiopathology*
Collagen Diseases / physiopathology
Fractures, Bone / physiopathology
Glucocorticoids / therapeutic use
Homeostasis / physiology
Hyperparathyroidism / physiopathology
Osteopetrosis / physiopathology
Osteoporosis / physiopathology*
Reg. No./Substance:
0/Antirheumatic Agents; 0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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