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Bone Disorders

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...

Bone Remodeling and Repair

Bone Remodeling and Repair

Bone Structure

Bone Structure

Within the skeletal system, the structure of a bone, or osseous tissue, can be exemplified in a long bone, like the femur, where there are two types of osseous tissue: cortical and cancellous.

Bone Remodeling

Bone Remodeling

Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.

Osteoclasts in Bone Remodeling

Osteoclasts in Bone Remodeling

Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...

Blood and Nerve Supply to the Bones

Blood and Nerve Supply to the Bones

Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...

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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

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Published on: January 29, 2018

Bone density testing: science, the media, and patient care.

Micol S Rothman, Paul D Miller, E Michael Lewiecki

Current Osteoporosis Reports

|March 25, 2014

Summary

Dual-energy X-ray absorptiometry (DXA) effectively diagnoses osteoporosis and assesses fracture risk, aiding early intervention. Current guidelines, individualized for patients, ensure optimal DXA testing intervals for cost-effective care.

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Area of Science:

Bone densitometry
Osteoporosis diagnosis
Fracture risk assessment

Background:

Dual-energy X-ray absorptiometry (DXA) is a cost-effective, noninvasive tool for osteoporosis diagnosis and therapy monitoring.
Early detection via DXA enables timely intervention, reducing fracture risk and healthcare costs.
Recent media coverage has questioned DXA's utility, potentially leading to underdiagnosis.

Purpose of the Study:

To advocate for the continued appropriate use of DXA in clinical practice.
To emphasize the importance of individualized patient care in determining DXA testing intervals.
To counter misinformation regarding DXA's cost-effectiveness and necessity.

Main Methods:

Review of current clinical practice guidelines for DXA screening and retesting.
Emphasis on individualized patient assessment for determining optimal testing frequency.
Analysis of the benefits of early osteoporosis detection through DXA.

Main Results:

DXA remains a valuable tool for osteoporosis diagnosis and fracture risk assessment.
Individualized care based on patient factors optimizes DXA testing intervals.
Adherence to guidelines ensures cost-effective healthcare by preventing costly fractures.

Conclusions:

Current clinical practice guidelines for DXA testing should be followed.
Individualizing DXA testing intervals based on patient factors is crucial.
Appropriate DXA use is essential for early osteoporosis detection and management, preventing fractures and saving healthcare costs.