Search tips
Search criteria 


Logo of jcinvestThe Journal of Clinical Investigation
J Clin Invest. 1983 October; 72(4): 1396–1409.
PMCID: PMC370424

Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss.


We devised a new method for examining the structural changes that occur in trabecular bone in aging and in osteoporosis. With simultaneous measurement of total perimeter and bone area in thin sections, indirect indices of mean trabecular plate thickness (MTPT) and mean trabecular plate density (MTPD) can be derived, such that trabecular bone volume = MTPD X MTPT. MTPD is an index of the probability that a scanning or test line will intersect a structural element of bone, and is the reciprocal of the mean distance between the midpoints of structural elements, multiplied by pi/2. We applied this method to iliac bone samples from 78 normal subjects, 100 patients with vertebral fracture, and 50 patients with hip fracture. The reduction in trabecular bone volume observed in normal subjects with increasing age was mainly due to a reduction in plate density, with no significant decrease in plate thickness. The further reduction in trabecular bone volume observed in patients with osteoporotic vertebral fracture was mainly due to a further reduction in plate density. There was a relatively smaller reduction in plate thickness that was statistically significant in males but not in females. Only in patients with hip fracture did trabecular thinning contribute substantially to the additional loss of trabecular bone in osteoporosis relative to age. These data indicate that age-related bone loss occurs principally by a process that removes entire structural elements of bone; those that remain are more widely separated and some may undergo compensatory thickening, but most slowly become reduced in thickness. We propose that the process of removal is initiated by increased depth of osteoclastic resorption cavities which leads to focal perforation of trabecular plates; this is followed by progressive enlargement of the perforations with conversion of plates to rods. The resulting structural changes are more severe in osteoporotic patients than in normal subjects, but have been completed in most patients before they develop symptoms.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Melsen F, Melsen B, Mosekilde L, Bergmann S. Histomorphometric analysis of normal bone from the iliac crest. Acta Pathol Microbiol Scand A. 1978 Jan;86(1):70–81. [PubMed]
  • Nordin BE, Aaron J, Speed R, Crilly RG. Bone formation and resorption as the determinants of trabecular bone volume in postmenopausal osteoporosis. Lancet. 1981 Aug 8;2(8241):277–279. [PubMed]
  • Whyte MP, Bergfeld MA, Murphy WA, Avioli LV, Teitelbaum SL. Postmenopausal osteoporosis. A heterogeneous disorder as assessed by histomorphometric analysis of Iliac crest bone from untreated patients. Am J Med. 1982 Feb;72(2):193–202. [PubMed]
  • Whitehouse WJ. Cancellous bone in the anterior part of the iliac crest. Calcif Tissue Res. 1977 May 31;23(1):67–76. [PubMed]
  • Pugh JW, Rose RM, Radin EL. Elastic and viscoelastic properties of trabecular bone: dependence on structure. J Biomech. 1973 Sep;6(5):475–485. [PubMed]
  • Merz WA, Schenk RK. Quantitative structural analysis of human cancellous bone. Acta Anat (Basel) 1970;75(1):54–66. [PubMed]
  • Whitehouse WJ. The quantitative morphology of anisotropic trabecular bone. J Microsc. 1974 Jul;101(Pt 2):153–168. [PubMed]
  • Wakamatsu E, Sissons HA. The cancellous bone of the iliac crest. Calcif Tissue Res. 1969;4(2):147–161. [PubMed]
  • Delling G. Age-related bone changes. Histomorphometric investigation of the structure of human cancellous bone. Curr Top Pathol. 1973;58:117–147. [PubMed]
  • Pesch HJ, Scharf HP, Lauer G, Seibold H. Der altersabhängige Verbundbau der Lendenwirbelkörper. Eine Struktur- und Formanalyse. Virchows Arch A Pathol Anat Histol. 1980;386(1):21–41. [PubMed]
  • Parfitt AM, Oliver I, Villanueva AR. Bone histology in metabolic bone disease: the diagnostic value of bone biopsy. Orthop Clin North Am. 1979 Apr;10(2):329–345. [PubMed]
  • Schwartz MP, Recker RR. Comparison of surface density and volume of human iliac trabecular bone measured directly and by applied stereology. Calcif Tissue Int. 1981;33(6):561–565. [PubMed]
  • Lips P, Netelenbos JC, Jongen MJ, van Ginkel FC, Althuis AL, van Schaik CL, van der Vijgh WJ, Vermeiden JP, van der Meer C. Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Relat Res. 1982;4(2):85–93. [PubMed]
  • Dambacher MA, Langlotz M, Olah AJ, Rüegsegger P. Differentialdiagnose der metabolischen Osteopathien. Orthopade. 1982 Apr;11(2):35–46. [PubMed]
  • Frost HM. The skeletal intermediary organization. Metab Bone Dis Relat Res. 1983;4(5):281–290. [PubMed]
  • Parfitt AM. Quantum concept of bone remodeling and turnover: implications for the pathogenesis of osteoporosis. Calcif Tissue Int. 1979 Aug 24;28(1):1–5. [PubMed]
  • Lips P, Courpron P, Meunier PJ. Mean wall thickness of trabecular bone packets in the human iliac crest: changes with age. Calcif Tissue Res. 1978 Nov 10;26(1):13–17. [PubMed]
  • Darby AJ, Meunier PJ. Mean wall thickness and formation periods of trabecular bone packets in idiopathic osteoporosis. Calcif Tissue Int. 1981;33(3):199–204. [PubMed]
  • Parfitt AM. The coupling of bone formation to bone resorption: a critical analysis of the concept and of its relevance to the pathogenesis of osteoporosis. Metab Bone Dis Relat Res. 1982;4(1):1–6. [PubMed]
  • Courpron P. Bone tissue mechanisms underlying osteoporoses. Orthop Clin North Am. 1981 Jul;12(3):513–545. [PubMed]
  • Cann CE, Genant HK. Precise measurement of vertebral mineral content using computed tomography. J Comput Assist Tomogr. 1980 Aug;4(4):493–500. [PubMed]
  • Heaney RP, Recker RR, Saville PD. Menopausal changes in bone remodeling. J Lab Clin Med. 1978 Dec;92(6):964–970. [PubMed]
  • Krølner B, Pors Nielsen S. Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci (Lond) 1982 Mar;62(3):329–336. [PubMed]
  • Heaney RP, Recker RR, Saville PD. Menopausal changes in calcium balance performance. J Lab Clin Med. 1978 Dec;92(6):953–963. [PubMed]
  • Reeve J, Green JR, Hesp R, Hulme P. Rates of new bone formation in patients with crush fracture osteoporosis. Clin Sci (Lond) 1982 Aug;63(2):153–160. [PubMed]
  • Crilly RG, Horseman A, Peacock M, Nordin BE. The vitamin D metabolites in the pathogenesis and management of osteoporosis. Curr Med Res Opin. 1981;7(5):337–348. [PubMed]
  • Crilly RG, Horsman A, Marshall DH, Nordin BE. Post-menopausal and corticosteroid-induced osteoporosis. Front Horm Res. 1977;5:53–75. [PubMed]

Articles from The Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation