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Diagnostic Criteria for Osteoporosis

Osteoporosis is defined as a metabolic bone disease "characterized by low bone mass and microarchitectural deterioration of bony tissue leading to enhanced bone fragility and a consequent increase in fracture risk.

World Health Organization (WHO) definition of osteoporosis is only applicable (at present) to Bone Mineral Density (BMD) measurements using DXA (Dual X-ray Absorptiometry)

BMD as measured by DXA is expressed as absolute BMD (g/cm2) and may be designated by either the number of standard deviations (SD) from the young normal mean (T score). The WHO developed guidelines for their use in the clinical diagnosis of osteoporosis and is based on the T score, with a T score of less than -1.0 being defined as osteopenic and a T score of less than -2.5 being referred as osteoporotic.

WHO Criteria for Osteoporosis

Category

Fracture Risk

Action

Normal

BMD < 1 SD below youngadult reference range

Below average

Be watchful for "clinical triggers"

Osteopenia

BMD 1-2.5 SD below young adult reference range

Above average

Consider prevention in peri/postmenopausal in women.

Be watchful for clinical triggers.

Possibly repeat investigations in 2-3 years.

Osteoporosis

BMD > 2.5 SD below young adult reference mean

High

Exclude secondary causes.

Therapeutic intervention indicated in most patients.

Severe Osteoporosis

BMD > 2.5 SD below young adult reference mean, plus 1 or more fragility fractures

Established osteoporosis

Exclude secondary causes.

Therapeutic intervention indicated in most patients.

 

References:

  1. World Health Organization Study Group on Assessment of Fracture Risk and Its Application to Screening and Postmenopausal Osteoporosis. Report of a WHO Study Group. Technical Report Series (No. 84), 1994

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Created: May 21, 2005
Last Modified: 10/23/2010

 
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