Histomorphometric classification of postmenopausal osteoporosis: implications for the management of osteoporosis.

AIMS To define and group static and dynamic iliac crest histomorphometric parameters in women with established osteoporosis. METHODS Iliac crest biopsy specimens from 146 white women were sectioned undecalcified and examined using image analysis. RESULTS Five distinct groups were defined on the basis of histomorphometric changes in cell function: group 1, decreased osteoblastic and osteoclastic activity; group 2, decreased osteoblastic and increased osteoclastic activity; group 3, increased osteoblastic and osteoclastic activity; group 4, no bone surface cell activity; and group 5, apparently normal osteoblastic and osteoclastic activity. CONCLUSIONS Five distinct subgroups of patients with postmenopausal osteoporosis can be defined based on changes in bone cell function. Defining cellular dysfunction in this way may be important for tailoring treatment regimens to the needs of individual patients.