Mnemonic

Bone Types and Structure

A memory aid for compact and cancellous bone and their organisation.

Expansion

Compact bone in osteons, cancellous bone in trabeculae

Expansion

Two architectures

  • Compact (cortical) bone - dense, forming the shaft. Organised into osteons (Haversian systems): concentric lamellae around a Haversian canal carrying vessels and nerves, linked by Volkmann’s canals
  • Cancellous (trabecular, spongy) bone - a lattice of trabeculae aligned along lines of stress, filled with marrow. Metabolically far more active, so it is lost first in osteoporosis, which is why vertebral and femoral neck fractures come early

Two tissue types

  • Lamellar bone - organised parallel collagen, strong. All mature bone
  • Woven bone - disorganised collagen, weak. Normal only in the fetus and in fracture callus; elsewhere it indicates Paget’s disease, fibrous dysplasia, osteosarcoma or hyperparathyroidism

Cells

  • Osteoblasts - build bone, express alkaline phosphatase and RANK ligand
  • Osteocytes - trapped osteoblasts in lacunae, communicating through canaliculi, acting as mechanosensors
  • Osteoclasts - multinucleate, from the monocyte lineage, resorbing bone via a ruffled border and acid secretion. Inhibited by bisphosphonates and denosumab

Osteocytes sense loading, which is why bone follows Wolff’s law, remodelling along lines of stress, and why immobility causes rapid bone loss.