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General Medicine

Osteoporosis and Osteopenia

Caitlin A. Nicholson, MD and Rahul Kapur, MD, CAQSM Reviewed 06/2020
 


BASICS

DESCRIPTION

A skeletal disease characterized by low bone mass, deterioration of bone tissue, and disruption of bone architecture that leads to compromised bone strength and an increased risk of ...

DIAGNOSIS

HISTORY

  • Review modifiable and nonmodifiable risk factors

  • Online FRAX tool: http://www.shef.ac.uk/FRAX/

  • Assess for commonly associated conditions.

PHYSICAL EXAM

  • Thoracic kyphosis, poor balance, de...

TREATMENT

  • Criteria for patients who benefit from treatment for their osteoporosis include:

    • All patients with a T-score ≤−2.5 with no risk factors

    • All postmenopausal women and men >50 years old who ha...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Weight-bearing exercises such as walking, jogging, stair climbing, and tai chi have been shown to decrease falls and fracture risk.

  • Yearly height...

REFERENCES

1
Christenson ES, Jiang X, Kagan R, et al. Osteoporosis management in post-menopausal women. Minerva Ginecol.  2012;64(3):181–194.
2
US Preventive Services Task Force. Screening for osteo...

CODES

ICD10

  • M85.80 Other specified disorders of bone density and structure, unspecified site

  • M81.0 Age-related osteoporosis w/o current pathological fracture

  • M80.00XA Age-rel osteopor w current path frac...

CLINICAL PEARLS

  • Regular weight-bearing exercise from adolescence onward is recommended for prevention.

  • Screen all women ≥65 years of age with DEXA scans.

  • Premenopausal women with osteoporosis should be ...

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Related Images
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FIG. 121.3. Scanning electron micrographs of subarticular bone showing that the trabeculae are thin plates of bone. Left: Normal bone. Right: In osteoporosis, the trabecular surface is particularly subject to erosion by osteoclasts, and the trabecular structure may be weakened to the point that collapse occurs.
FIG. 121.3. Scanning electron micrographs of subarticular bone showing that the trabeculae are thin plates of bone. Left: Normal bone. Righ...
Figure 22-5 Osteoporosis. A: Normal cancellous (spongy) bone. B: Osteoporotic bone. Bone organization is correct, but the lattice is thin and less bone mass is present.
Figure 22-5 Osteoporosis. A: Normal cancellous (spongy) bone. B: Osteoporotic bone. Bone organization is correct, but the lattice is thin a...
Figure 22-6 Osteoporosis of the spine. The degree of severity to which the vertebral bodies are affected decreases from left to right.
Figure 22-6 Osteoporosis of the spine. The degree of severity to which the vertebral bodies are affected decreases from left to right.
Figure 22-8 Collapse fracture of a vertebral body. This is a midline section of the spine in a patient with osteoporosis.
Figure 22-8 Collapse fracture of a vertebral body. This is a midline section of the spine in a patient with osteoporosis.
FIGURE 26-26. Osteoporosis. Femoral head of an 82-year-old female with osteoporosis and a femoral neck fracture (right) compared with a normal control cut to the same thickness (left).
FIGURE 26-26. Osteoporosis. Femoral head of an 82-year-old female with osteoporosis and a femoral neck fracture (right) compared with a nor...
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