Fig. 2
From: The challenges of diagnosing osteoporosis and the limitations of currently available tools
Determinants of bone strength. Bone strength is a composite summation of numerous skeletal characteristics. The size of bone increases with age and with puberty. Ultimate bone size also has a large genetic contribution. Genetics and habitual loading determine bone shape. The architecture of bone is a complex interplay among many structural components. Cortical diameter, thickness and porosity contribute to cortical strength. The number, thickness, and the connectivity of plates and rods determine trabecular bone strength. Bone composition is difficult to measure non-invasively. The degree of collagen crosslinking and the density of collagen contribute to bone matrix strength. Newly formed protein matrix subsequently becomes mineralized and how the hydroxyapatite crystals are arranged within the matrix and the degree of mineralization contribute to bone hardness and strength