Other terms: age-related or involutional 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
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
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
Other terms: age-related or involutional 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
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
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