Osteoporosis classification scheme

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]

Overview

Osteoporosis is defined as the disease state with T-score less than -2.5 for decreased Bone mineral density on a DEXA scan. Osteoporosis may be primary (without any underlying cause) or secondary (having an underlying cause).

Classification

There is a spectrum of disease ranging from osteopenia (milder and earlier bone loss) to osteoporosis (later more severe bone loss).

Osteopenia

Osteopenia which is defined as bone mineral density ranging from less than -1.0 and more than -2.5, can be a precursor condition to osteoporosis.

Osteoporosis

In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old sex-matched healthy person average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture. Osteoporosis is most common in women after the menopause, when it is called postmenopausal osteoporosis, but may develop in men and premenopausal women in the presence of particular hormonal disorders and other chronic diseases or as a result of smoking andmedications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). It is also a sign of normal aging, in contrast to osteoporosis which is present in pathologic aging.