Prof.

of Rheumatology, Cairo University

 Objectives

1. Explain the concept of bone strength.

2. Understand how the pathological changes in
OP can lead to compromised strength and
increased fracture risk.
3. Apply these concepts to clarify many of the
facts and controversies in the field of OP.

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Matrix Matrix

Matrix

Mineral Mineral

Mineral

Normal Osteoporosis Osteomalacia

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 a skeletal disorder characterized by
compromised bone strength predisposing
a person to an increased risk of fracture.

NIH Consensus Development Panel on Osteoporosis. JAMA 285 (2001): 785-95

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 In post-menopausal osteoporosis, remodeling is
pathologically increased and unbalanced.
 Bone strength is the issue that matters in pathogenesis
of osteoporotic fractures.
 Not only bone mass but also the quality of bone are
important in determining bone strength and the risk of
fracture in osteoporosis.
 Preservation of the trabecular architecture is the key
factor to improve bone strength at the cancellous bone.
While restoration of the cortical porosity is the key
factor to improve bone strength at the cortical sites.