Regional variation in bone turnover at the iliac crest versus the greater trochanter

Hughes-Austin, Jan M.<sup>1</sup>; Dwight, Kathryn D.<sup>1</sup>; Ginsberg, Charles<sup>2,3</sup>; Tipps, Ann<sup>4</sup>; Salusky, Isidro B.<sup>5</sup>; Pereira, Renata C.<sup>5</sup>; Ix, Joachim H.<sup>2,3</sup>

Affiliations

¹Department of Orthopaedic Surgery, University of California San Diego, La Jolla, CA, USA

²Division of Nephrology-Hypertension, Department of Medicine, University of California, San Diego, La Jolla, CA, USA

³Nephrology Section, Veterans Affairs of San Diego, San Diego, CA, USA

⁴Department of Pathology, University of California, San Diego, La Jolla, CA, USA

⁵Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA

Abstract

Background: Iliac crest bone biopsy with histomorphometry is the gold standard for diagnosis of abnormalities in bone turnover, yet fractures more frequently occur at the greater trochanter of the hip. Whether bone turnover is similar at these two anatomic sites within individuals is uncertain.

Methods: We collected bone biopsy samples from the ipsilateral iliac crest and greater trochanter in 9 deceased individuals undergoing autopsies at an academic medical center between March–August 2018. We measured 14 static bone histomorphometry parameters including osteoclast number (N.Oc/T.A), eroded surface (ES/BS), trabecular separation (Tb.Sp), osteoclast surface (Oc.S/BS) and osteoid volume (OV/BV) as markers of bone turnover, mineralization, and volume (TMV), and evaluated the correlation of these markers between the iliac crest and greater trochanter.

Results: Average age at time of death was 58 ± 15 years, 2 were women, and average time from death to autopsy was 2.9 ± 1.8 days. Overall, correlations of the markers of bone turnover across the two sites were poor, ranging from as low as 0 for Tb.Sp (p = 1.0) to as high as 0.583 for Oc.S/BS (p = 0.102).

Conclusions: Static histomorphometric measures of bone turnover at the iliac crest may not provide reliable information about turnover at other anatomic sites.

Links

DOI: 10.1016/j.bone.2020.115604

PubMed: 32827849

WoS: 000604733200016

History

Received: 2020-04-4

Revised: 2020-08-16

Accepted: 2020-08-16

Online: 2020-08-20

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