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Primary Osteoporosis
Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Dual-energy x-ray absorptiometry (DEXA)
              • Bone mineral density (BMD)
            • Synonyms

              • Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
                • Other terms: Age related or involutional
            • Definitions

              • Osteoporosis: ↓ amount of histologically normal bone
                • For clinical purposes, defined by BMD relative to standard population
              • Senile osteoporosis: Osteoporosis occurring in individuals > 75 years old
              • Osteopenia: Different meanings depending on context
                • Radiographic appearance of decreased bone density
                  • Osteoporosis is one of many causes
                • DEXA interpretation applies to BMD between normal & osteoporosis; T score between -1 and -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: Results from normal stress on abnormal bone
              • Severe or established osteoporosis
                • T score ≤ -2.5 and 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

                                                1. 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
                                                2. 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
                                                3. Adams JE: Quantitative computed tomography. Eur J Radiol. 71(3):415-24, 2009
                                                4. Bauer JS et al: Advances in osteoporosis imaging. Eur J Radiol. 71(3):440-9, 2009
                                                5. Krestan C et al: Imaging of insufficiency fractures. Eur J Radiol. 71(3):398-405, 2009
                                                6. Genant HK et al: Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 8(9):1137-48, 1993
                                                7. International Society for Clinical Densitometry: www.ISCD.org
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Dual-energy x-ray absorptiometry (DEXA)
                                                            • Bone mineral density (BMD)
                                                          • Synonyms

                                                            • Primary osteoporosis encompasses postmenopausal (type I) & senile (type II) osteoporosis
                                                              • Other terms: Age related or involutional
                                                          • Definitions

                                                            • Osteoporosis: ↓ amount of histologically normal bone
                                                              • For clinical purposes, defined by BMD relative to standard population
                                                            • Senile osteoporosis: Osteoporosis occurring in individuals > 75 years old
                                                            • Osteopenia: Different meanings depending on context
                                                              • Radiographic appearance of decreased bone density
                                                                • Osteoporosis is one of many causes
                                                              • DEXA interpretation applies to BMD between normal & osteoporosis; T score between -1 and -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: Results from normal stress on abnormal bone
                                                            • Severe or established osteoporosis
                                                              • T score ≤ -2.5 and 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

                                                                                              1. 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
                                                                                              2. 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
                                                                                              3. Adams JE: Quantitative computed tomography. Eur J Radiol. 71(3):415-24, 2009
                                                                                              4. Bauer JS et al: Advances in osteoporosis imaging. Eur J Radiol. 71(3):440-9, 2009
                                                                                              5. Krestan C et al: Imaging of insufficiency fractures. Eur J Radiol. 71(3):398-405, 2009
                                                                                              6. Genant HK et al: Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 8(9):1137-48, 1993
                                                                                              7. International Society for Clinical Densitometry: www.ISCD.org