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Osteopenia and Osteoporosis
Umesh D. Oza, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Osteopenia
            • Bone density that is not normal, but also not as low as osteoporosis
              • According to WHO criteria, osteopenia is defined as BMD lying 1.0-2.5 standard deviations below average value for young healthy women (T-score -1.0 < -2.5 SD)
          • Osteoporosis
            • Osteoporosis-related bone loss occurs when bone resorption exceeds bone formation
              • Peak bone mass occurs in the 20s
              • Bone loss increases with age and after menopause 
            • Systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with consequent increase in bone fragility and susceptibility to fracture
              • According to World Health Organization (WHO) criteria, osteoporosis is defined as BMD lying 2.5 standard deviations or more below average value for young healthy women (T-score < -2.5 SD)
          • T-score
            • Calculated by taking difference between patient's measured BMD and mean BMD of healthy young adults, matched for gender and ethnic group, and expressing difference relative to young adult population SD
          • Z-score
            • Compared with mean BMD expected for healthy subject matched for age, gender, and ethnic origin

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  • Artifacts and Quality Control

                    PATHOLOGY

                    • Staging, Grading, & Classification

                      CLINICAL ISSUES

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            • Risk Factors for Osteoporosis

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                • Reporting Tips

                                  Selected References

                                  1. Pisani P et al: Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques. World J Radiol. 5(11):398-410, 2013
                                  2. Whitaker M et al: Bisphosphonates for osteoporosis--where do we go from here? N Engl J Med. 366(22):2048-51, 2012
                                  3. Blake GM et al: The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J. 83(982):509-17, 2007
                                  4. Kanis JA: Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 359(9321):1929-36, 2002
                                  5. Kanis JA et al: Risk factors in osteoporosis. Maturitas. 30(3):229-33, 1998
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Diagnostic Checklist

                                        TERMINOLOGY

                                        • Definitions

                                          • Osteopenia
                                            • Bone density that is not normal, but also not as low as osteoporosis
                                              • According to WHO criteria, osteopenia is defined as BMD lying 1.0-2.5 standard deviations below average value for young healthy women (T-score -1.0 < -2.5 SD)
                                          • Osteoporosis
                                            • Osteoporosis-related bone loss occurs when bone resorption exceeds bone formation
                                              • Peak bone mass occurs in the 20s
                                              • Bone loss increases with age and after menopause 
                                            • Systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with consequent increase in bone fragility and susceptibility to fracture
                                              • According to World Health Organization (WHO) criteria, osteoporosis is defined as BMD lying 2.5 standard deviations or more below average value for young healthy women (T-score < -2.5 SD)
                                          • T-score
                                            • Calculated by taking difference between patient's measured BMD and mean BMD of healthy young adults, matched for gender and ethnic group, and expressing difference relative to young adult population SD
                                          • Z-score
                                            • Compared with mean BMD expected for healthy subject matched for age, gender, and ethnic origin

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • CT Findings

                                              • Ultrasonographic Findings

                                                • Imaging Recommendations

                                                  • Artifacts and Quality Control

                                                    PATHOLOGY

                                                    • Staging, Grading, & Classification

                                                      CLINICAL ISSUES

                                                      • Demographics

                                                        • Natural History & Prognosis

                                                          • Treatment

                                                            • Risk Factors for Osteoporosis

                                                              DIAGNOSTIC CHECKLIST

                                                              • Image Interpretation Pearls

                                                                • Reporting Tips

                                                                  Selected References

                                                                  1. Pisani P et al: Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques. World J Radiol. 5(11):398-410, 2013
                                                                  2. Whitaker M et al: Bisphosphonates for osteoporosis--where do we go from here? N Engl J Med. 366(22):2048-51, 2012
                                                                  3. Blake GM et al: The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J. 83(982):509-17, 2007
                                                                  4. Kanis JA: Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 359(9321):1929-36, 2002
                                                                  5. Kanis JA et al: Risk factors in osteoporosis. Maturitas. 30(3):229-33, 1998