Foundation Bone density vs bone quality: What’s a ...

REVIEW. Angelo Licata, MD, PhD*. Director, Center for Space Medicine; Consultant, Depart- ments of Biomedical Engineering and Endocrinology, Diabetes, and Metabolism, Metabolic bone Center, cleveland clinic ; Editor-in-Chief, Clinical Reviews in bone and Mineral Metabolism; Editor-In-Chief, National Osteoporosis Foundation Osteoporosis Clinical Updates bone density vs bone quality : What's a clinician to do? Abstract M ost clinicians were taught directly or indirectly that bone density is the gauge for assessing bone strength and the response Studies of the epidemiology of osteoporosis and of drug treatments for it have challenged the concept that denser to antiosteoporotic treatment. In recent years, bone means stronger bone . bone strength or resistance to however, the concept of bone strength has fracture is not easily measured by routine densitometry, moved beyond density alone and has expanded to include a number of characteristics of bone being a function of both density and quality .

332 CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 76 • NUMBER 6 JUNE 2009 bone QuAlity a specific cutoff of bone mass as a risk for frac-ture and not the statistical T scores or Z scores

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