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JAMES W. HALL III, M.D.; B. J. KENNEDY, M.D.

Arch Intern Med. 1961;108(3):448-455.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Osteoporosis occurs in elderly persons and as a secondary feature of certain diseases. The pathologic process is one of deficient bone matrix, rather than mineral, and has been defined by Bartter as: "a metabolic bone disease in which the total body mass of bone is less than that of a normally active subject of comparable size as a result of failure of new bone formation." 1 It should be added that features of increased bone destruction may exist as well in some types of osteoporosis. The lack of a fundamental understanding of the precise mechanisms of bone formation, maintenance, and destruction precludes adequate classification of the various osteoporotic conditions; however, the following scheme is a clinically useful approach (modified from Bartter¹ and Albright²):

1. Decreased osteoblastic activity: Disuse Estrogen lack (postmenopausal) Osteogenesis imperfecta Hypophosphatasia
   
2. Reduced available nitrogenous components: Starvation (including malabsorption syndromes) Deficiency of nitrogen retaining hormones
   

Author Affiliations
MINNEAPOLIS

Fellow in Internal Medicine (Dr. Hall), and Associate Professor of Medicine (Dr. Kennedy), University of Minnesota Medical Center.; From the Department of Internal Medicine of the University of Minnesota Medical Center.

Footnotes
Submitted for publication May 25, 1960.

Supported by a research grant (CY 3143) from the National Cancer Institute, National Institutes of Health, Public Health Service.

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