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[Diagnosis of osteoporosis from the viewpoint of bone quality].

It is generally known that approximately 70 percent of bone strength is explained by bone mineral density, and the remaining 30 percent by "bone quality". Especially, in the monitoring of treatment, bone mineral density cannot fully explain the efficacy upon the risk of fracture. "Bone quality" has two aspects: structure property and material property. They are both influenced by bone turnover and have a relation to bone strength. From the viewpoint of diagnosis of osteoporosis, the factors of bone quality that can be clinically evaluated, are bone biomarkers as indices of bone remodeling, and structure property including bone geometry and trabecular microstructure. This article discusses the evaluation of bone quality and its clinical significance.