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Normal Bone Anatomy and Physiology

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Clarke, Bart·2008·Clinical Journal of the American Society of Nephrology

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Abstract

This review describes normal bone anatomy and physiology as an introduction to the subsequent articles in this section that discuss clinical applications of iliac crest bone biopsy. The normal anatomy and functions of the skeleton are reviewed first, followed by a general description of the processes of bone modeling and remodeling. The bone remodeling process regulates the gain and loss of bone mineral density in the adult skeleton and directly influences bone strength. Thorough understanding of the bone remodeling process is critical to appreciation of the value of and interpretation of the results of iliac crest bone histomorphometry. Osteoclast recruitment, activation, and bone resorption is discussed in some detail, followed by a review of osteoblast recruitment and the process of new bone formation. Next, the collagenous and noncollagenous protein components and function of bone extracellular matrix are summarized, followed by a description of the process of mineralization of newly formed bone matrix. The actions of biomechanical forces on bone are sensed by the osteocyte syncytium within bone via the canalicular network and intercellular gap junctions. Finally, concepts regarding bone remodeling, osteoclast and osteoblast function, extracellular matrix, matrix mineralization, and osteocyte function are synthesized in a summary of the currently understood functional determinants of bone strength. This information lays the groundwork for understanding the utility and clinical applications of iliac crest bone biopsy.

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Authors: Clarke, B.
Affiliations: Mayo Clinic (US)
Corresponding author: Clarke, Bart
ORCID: Clarke, Bart
Venue: Clinical Journal of the American Society of Nephrology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2008-11
Volume: 3
Issue: Supplement_3
Pages: S131-S139
ISSN: 1555-9041 (ISSN-L)
DOI: 10.2215/cjn.04151206
PMC: PMC3152283
OpenAlex: W2133514604
Cited by: 2,192
References: 360
Citations by year: 2026: 98 · 2025: 134 · 2024: 177 · 2023: 153 · 2022: 177 · 2021: 213 · 2020: 191 · 2019: 168 · 2018: 179 · 2017: 165 · 2016: 137 · 2015: 103 · 2014: 91 · 2013: 85 · 2012: 49
FWCI: 21.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Clinical Journal of the American Society of Nephrology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
Keywords: bone anatomy, bone physiology, bone remodeling, bone modeling, bone mineral density, bone strength, osteoclasts, bone resorption, osteoblasts, bone formation, bone matrix, collagen, matrix mineralization, osteocytes, bone mechanotransduction, gap junctions, iliac crest bone biopsy, bone histomorphometry
MeSH terms: Bone and Bones, Bone Development, Calcium, Collagen, Extracellular Matrix, Humans, Osteoblasts, Osteoclasts, Osteocytes, Vitamin D, Bone Remodeling, Wnt Proteins, RANK Ligand

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