Lexicon
Bone Density
Also known as Bone mineral density, BMD
Definition
Osteoporosis is a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to an increased risk of fragility fractures, and bone mineral density is the most common indicator of bone health. [1] [2] The diagnosis of osteoporosis centres on the assessment of bone mineral density, which is an established determinant of the risk of future fracture. [3] The World Health Organization proposed a four-point scale describing bone status as normal, low bone mass, osteoporosis, and established osteoporosis. [4]
How it works
Bone mass declines and the risk of fractures increases as people age, especially as women pass through the menopause. [5] Low bone density and previous fractures are risk factors for almost all types of fracture, though each type of fracture also has its own unique risk factors. [5] The predictive value of bone mineral density can be enhanced by other factors such as age, previous fragility fracture, family history of hip fracture, and use of oral corticosteroids. [3]
Connected concepts
How it's measured
The recommended site for diagnosis is the proximal femur measured with dual-energy X-ray absorptiometry, and T-scores used to categorise bone health are determined by comparing bone mineral density to reference standards. [3] [2] The reference standard proposed for describing osteoporosis is bone mineral density measured at the femoral neck with DXA, using the NHANES III reference database for women aged 20 to 29 years. [6] DXA measurements are influenced by technical factors including instrument quality control, patient positioning, and the selection of reference ranges for T-scores and Z-scores. [7] Complementary imaging methods such as high-resolution peripheral quantitative computed tomography, quantitative ultrasound, and the trabecular bone score can provide information on bone microarchitecture and quality that DXA alone does not capture. [2] [8]
Community knowledge
## Menopause And Bone Loss Bone loss accelerates sharply across the menopause transition, and faculty describe both the biology and the…
The longevitydocs community's collective insight and shared knowledge on this concept — across text, video, audio and images from members and faculty, reserved for members.
Learn about our Membership planReferences
- 1.Anam AK, Insogna K. Update on Osteoporosis Screening and Management. Med Clin North Am · 2021
- 2.Sangondimath G, Sen RK, T FR. DEXA and Imaging in Osteoporosis. Indian J Orthop · 2023
- 3.Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet · 2002
- 4.Cooper C, Aihie A. Osteoporosis. Baillieres Clin Rheumatol · 1995
- 5.Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet · 2002
- 6.Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ, Khaltaev N. A reference standard for the description of osteoporosis. Bone · 2008
Community discussion
Clinical pearls and discussion posted by community members on this concept — signed contributions, reserved for members.
Learn about our Membership plan