osteopenia
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Introduction
Osteopenia is a general term for low bone mass.
Etiology
- osteoporosis*
- primary
- postmenopausal (I)
- senile (II)
- idiopathic in younger men & women
- Secondary
- primary
- Cushing's syndrome (includes glucocorticoid therapy)
- hyperthyroidism
- hypogonadism in men
- immobilization
- chronic heparin administration
- osteogenesis imperfecta
- Primary hyperparathyroidism
- Osteomalacia
- Myeloma
- Mastocytosis
- Renal osteodystrophy
* minimal trauma fracture makes diagnosis of osteoporosis
Radiology
- bone mineral density (T-score -1 to -2.5)
- repeat in 2 years if osteopenia not reaching criteria for treatment with bisphosphonate[5]
Management
- calcium 1200 mg/day for men & women > 50 years preferably from dietary sources & vitamin D 600 IU/day, 800 IU/day recommended for elderly > 71 years[6]
- alendronate reduces vertebral fractures with osteopenia at the femoral neck[2]
- not cost-effective when only risk factors for fracture are age & bone mineral density[3]
- initiate bisphophate treatment in postmenopausal women & in men age >= 50 years with low bone mass (T-score -1 to -2.5, osteopenia) at the femoral neck, total hip, or spine & 10-year hip fracture probability >= 3% or a 10-yr all major osteoporosis-related fracture probability of >= 20% based on the FRAX fracture risk assessment tool[4][5]
- FDA approves vibrating belt to help women[7]
More general terms
More specific terms
References
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 500
- ↑ 2.0 2.1 Journal Watch 25(8):64-65, 2005 Quandt SA, Thompson DE, Schneider DL, Nevitt MC, Black DM; Fracture Intervention Trial Research Group. Effect of alendronate on vertebral fracture risk in women with bone mineral density T scores of-1.6 to -2.5 at the femoral neck: the Fracture Intervention Trial. Mayo Clin Proc. 2005 Mar;80(3):343-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15757015
- ↑ 3.0 3.1 Journal Watch 25(11):86, 2005 Schousboe JT, Nyman JA, Kane RL, Ensrud KE. Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women. Ann Intern Med. 2005 May 3;142(9):734-41. Summary for patients in: Ann Intern Med. 2005 May 3;142(9):I36. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15867405
McClung MR. Osteopenia: to treat or not to treat? Ann Intern Med. 2005 May 3;142(9):796-7. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15867413 - ↑ 4.0 4.1 Prescriber's Letter 15(4): 2008 New guideline for prevention and treatment of osteoporosis from the National Osteoporosis Foundation Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240404&pb=PRL (subscription needed) http://www.prescribersletter.com
CLINICIAN'S GUIDE TO PREVENTION AND TREATMENT OF OSTEOPOROSIS National Osteoporosis Foundation, 2008 http://www.nof.org/professionals/NOF_Clinicians%20_Guide.pdf - ↑ 5.0 5.1 5.2 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 6.0 6.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ 7.0 7.1 Frellick M FDA Approves Vibrating Belt to Help Women With Osteopenia Keep Bone Strength. Medscape. January 25, 2024 https://www.medscape.com/viewarticle/fda-approves-vibrating-belt-help-women-osteopenia-keep-bone-2024a10001u2