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Osteoporosis and Osteopenia

Rahul Kapur, MD and Benjamin E.M. Rosenstein, MD, MA, CAQGM Reviewed 05/2023
 


BASICS

DESCRIPTION

A skeletal disease characterized by low bone mass, with disruption of bone architecture leading to compromised bone strength and risk of fracture. 

EPIDEMIOLOGY

  • Predominant age: elderl...

DIAGNOSIS

HISTORY

  • Review modifiable and nonmodifiable risk factors

  • Online risk factor assessment tool (FRAX): http://www.shef.ac.uk/FRAX/

  • Assess for commonly associated conditions.

PHYSICAL EXAM

  • Thoracic k...

TREATMENT

  • Criteria for patients who benefit from treatment for their osteoporosis includes the following:

    • Patients T-score ≤−2.5 with no risk factors.

    • All postmenopausal women and men >50 years old w...

ONGOING CARE

Shared decision-making with the patient regarding treatment 

FOLLOW-UP RECOMMENDATIONS

  • Lifestyle modifications with strength and balance exercises

  • Optimization of calcium and vitamin D

  • Repeat...

REFERENCES

1
Reid HW, Selvan B, Batch BC, Lee RH. The break in FRAX: equity concerns in estimating fracture risk in racial and ethnic minorities. Journal of the American Geriatrics Society. 2021;69(9):...

ADDITIONAL READING

Camacho PM, Petak SM, et al. American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treat...

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

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

  • Premenopausal women with osteoporosis and those not responding to treatment should be screened for secondary causes.

  • Bisphosphonates ar...

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