Low Bone Mass (WHO) Flashcards
What T-score defines low bone mass (osteopenia)?
T-score between -1.0 and -2.5 (including -1.0 but not including -2.5)
Why are majority of fractures in those with low bone mass?
Because of the large number of individuals with bone mass in this range.
What is the WHO definition of low bone mass (osteopenia) based on BMD?
BMD between 1.0 and 2.5 Standard Deviations below that of the mean level for a young-adult reference population.
What group of women do WHO diagnostic criteria for low bone mass apply to?
Post-menopausal women
What group of men do WHO diagnostic criteria for low bone mass apply to?
Men over age 50 years
The WHO diagnostic criteria for low bone mass is applied to BMD measurement by _____ DXA at _____ sites?
Central DXA at the lumbar spins and femoral neck
Is Rheumatoid Arthritis associated with low bone mass?
Yes
What dose and duration of glucocorticoids are associated with low bone mass?
Glucocorticoids in a daily dose of more than or equal to 5 mg prednisone or equivalent for more than or equal to three months.
Does pharmacologic therapy reduce fracture risk in those with low bone density?
Yes
When should FDA approved medical therapies be considered in those with low bone mass?
A U.S.-adapted WHO 10-year probability of:
- a hip fracture of more than or equal to 3%
Or
- any major osteoporosis-related fracture of more than or equal to 20%
Is the evidence supporting pharmacotherapy reducing fractures in patients with low bone mass but no fractures strong?
No
Which term is preferred?
- osteopenia
- low bone mass
- low bone density
Low bone mass or low bone density
Are people with low bone mass necessarily at high fracture risk?
No
What is the preferred term for paediatric DXA reports where the Z-score is less than or equal to -2.0 Standard Deviations?
Low bone mass or low BMD
Do inflammatory bowel diseases (ulcerative colitis and Crohn’s) increase the risk of low bone mass and fragility fractures?
Yes
Is low bone mass indicative of future bone loss?
Not necessarily - it may or may not be.
What may a Z-score of less than -1.5 be indicative of?
Possible secondary causes for low bone mass
Do artifacts on DXA appear to have greater affect on BMD in patients with high or low bone density?
Low bone density
Name three strong predictors of low bone mass in post-menopausal women.
- body weight less than 70 kg (154 lb)
- increasing age
- no current use of estrogen
Men are generally older than women at any given level of low bone density.
True or false?
True
Low bone mass can be the presenting compliant of celiac’s disease.
True or false?
True
Several mast cell products have been implicated in low bone density.
True or false?
True
Has an association between low bone density and cardiovascular risk been found?
Yes
What three genetic defects (resulting in syndromes) are associated with low bone density in childhood?
- Turner’s syndrome
- Down’s syndrome
- Klinefelter’s syndrome
Should modifiers such as mild, moderate or severe be used to describe low bone mass?
No
Is the reference data for pQCT in children and adolescent sufficient for the diagnosis of low bone mass?
No
What percentage of fractures occur in those with low bone mass?
More than 50%
