Assessment of osteoporosis at autopsy: mechanical methods compared to radiological and histological techniques.

Osteoporosis is a common problem in the elderly female population and pathological fractures are a frequent complication, but how should the pathologist assess the severity of the disease at autopsy? In this study we have compared subjective, semi-quantitative assessments of rib fracturability, vertebral compressibility, Singh index and histomorphometric methods against a 'gold standard' assessment, namely the force required to fracture the femoral neck. We have shown good correlations between rib fracturability. Singh index and the standard chosen. Poor correlation was shown between histomorphometric techniques and the standard. Our findings suggest that gross rib fracturability is a good indicator of osteoporosis in as far as bone fragility is an indicator of the severity of osteoporosis. However, as the population under examination was small, further studies in this area are clearly warranted in order to extend these findings.