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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
- Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
- Other terms: age-related or involutional osteoporosis
- Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
Definitions
- Osteoporosis: ↓ amount of histologically normal bone
- For clinical purposes, defined by bone mineral density (BMD) relative to standard population
- Senile osteoporosis: osteoporosis occurring in individuals > 75 years old
- Osteopenia: different meanings depending on context
- Radiographic appearance of ↓ bone density
- Osteoporosis is 1 of many causes
- Dual-energy x-ray absorptiometry (DXA) interpretation applies to BMD between normal & osteoporosis; T score between -1 & -2.5
- Radiographic appearance of ↓ bone density
- Fragility fracture: results from minor trauma, such as fall from standing height
- Typically occurs in vertebral body, femoral neck, or distal radius (Colles fracture)
- Insufficiency fracture: stress fracture that results from normal stress on abnormal bone
- Severe or established osteoporosis
- T score ≤ -2.5 & fragility fracture
- Osteoporosis: ↓ amount of histologically normal bone
IMAGING
General Features
Imaging Recommendations
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Dual-Energy X-Ray Absorptiometry
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Future Directions
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
- International Society for Clinical Densitometry. Accessed December 27, 2021. www.ISCD.org
- Baim S et al: Approaches to fracture risk assessment and prevention. Curr Osteoporos Rep. 19(2):158-65, 2021
- Link TM et al: Update on imaging-based measurement of bone mineral density and quality. Curr Rheumatol Rep. 22(5):13, 2020
- Jang S et al: Opportunistic osteoporosis screening at routine abdominal and thoracic CT: normative L1 trabecular attenuation values in more than 20 000 adults. Radiology. 291(2):360-7, 2019
- Ross AB et al: Diagnostic accuracy of an abbreviated MRI protocol for detecting radiographically occult hip and pelvis fractures in the elderly. Skeletal Radiol. 48(1):103-8, 2019
- Steiner B et al: Prescreening for osteoporosis with quantitative ultrasound in postmenopausal white women. J Ultrasound Med. 38(6):1553-9, 2019
- Link TM: Radiology of osteoporosis. Can Assoc Radiol J. 67(1):28-40, 2016
- Marques A et al: The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis. 74(11):1958-67, 2015
- Krappinger D et al: Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data. Skeletal Radiol. 41(3):299-304, 2012
- Link TM: Osteoporosis imaging: state of the art and advanced imaging. Radiology. 263(1):3-17, 2012
- Adams JE: Quantitative computed tomography. Eur J Radiol. 71(3):415-24, 2009
- Bauer JS et al: Advances in osteoporosis imaging. Eur J Radiol. 71(3):440-9, 2009
- Krestan C et al: Imaging of insufficiency fractures. Eur J Radiol. 71(3):398-405, 2009
- Genant HK et al: Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 8(9):1137-48, 1993
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
- Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
- Other terms: age-related or involutional osteoporosis
- Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
Definitions
- Osteoporosis: ↓ amount of histologically normal bone
- For clinical purposes, defined by bone mineral density (BMD) relative to standard population
- Senile osteoporosis: osteoporosis occurring in individuals > 75 years old
- Osteopenia: different meanings depending on context
- Radiographic appearance of ↓ bone density
- Osteoporosis is 1 of many causes
- Dual-energy x-ray absorptiometry (DXA) interpretation applies to BMD between normal & osteoporosis; T score between -1 & -2.5
- Radiographic appearance of ↓ bone density
- Fragility fracture: results from minor trauma, such as fall from standing height
- Typically occurs in vertebral body, femoral neck, or distal radius (Colles fracture)
- Insufficiency fracture: stress fracture that results from normal stress on abnormal bone
- Severe or established osteoporosis
- T score ≤ -2.5 & fragility fracture
- Osteoporosis: ↓ amount of histologically normal bone
IMAGING
General Features
Imaging Recommendations
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Dual-Energy X-Ray Absorptiometry
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Future Directions
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
- International Society for Clinical Densitometry. Accessed December 27, 2021. www.ISCD.org
- Baim S et al: Approaches to fracture risk assessment and prevention. Curr Osteoporos Rep. 19(2):158-65, 2021
- Link TM et al: Update on imaging-based measurement of bone mineral density and quality. Curr Rheumatol Rep. 22(5):13, 2020
- Jang S et al: Opportunistic osteoporosis screening at routine abdominal and thoracic CT: normative L1 trabecular attenuation values in more than 20 000 adults. Radiology. 291(2):360-7, 2019
- Ross AB et al: Diagnostic accuracy of an abbreviated MRI protocol for detecting radiographically occult hip and pelvis fractures in the elderly. Skeletal Radiol. 48(1):103-8, 2019
- Steiner B et al: Prescreening for osteoporosis with quantitative ultrasound in postmenopausal white women. J Ultrasound Med. 38(6):1553-9, 2019
- Link TM: Radiology of osteoporosis. Can Assoc Radiol J. 67(1):28-40, 2016
- Marques A et al: The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis. 74(11):1958-67, 2015
- Krappinger D et al: Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data. Skeletal Radiol. 41(3):299-304, 2012
- Link TM: Osteoporosis imaging: state of the art and advanced imaging. Radiology. 263(1):3-17, 2012
- Adams JE: Quantitative computed tomography. Eur J Radiol. 71(3):415-24, 2009
- Bauer JS et al: Advances in osteoporosis imaging. Eur J Radiol. 71(3):440-9, 2009
- Krestan C et al: Imaging of insufficiency fractures. Eur J Radiol. 71(3):398-405, 2009
- Genant HK et al: Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 8(9):1137-48, 1993
