Low Bone Mass (WHO)

Question 1

What T-score defines low bone mass (osteopenia)?

Answer 1

T-score between -1.0 and -2.5 (including -1.0 but not including -2.5)

Question 2

Why are majority of fractures in those with low bone mass?

Answer 2

Because of the large number of individuals with bone mass in this range.

Question 3

What is the WHO definition of low bone mass (osteopenia) based on BMD?

Answer 3

BMD between 1.0 and 2.5 Standard Deviations below that of the mean level for a young-adult reference population.

Question 4

What group of women do WHO diagnostic criteria for low bone mass apply to?

Answer 4

Post-menopausal women

Question 5

What group of men do WHO diagnostic criteria for low bone mass apply to?

Answer 5

Men over age 50 years

Question 6

The WHO diagnostic criteria for low bone mass is applied to BMD measurement by _____ DXA at _____ sites?

Answer 6

Central DXA at the lumbar spins and femoral neck

Question 7

Is Rheumatoid Arthritis associated with low bone mass?

Answer 7

Yes

Question 8

What dose and duration of glucocorticoids are associated with low bone mass?

Answer 8

Glucocorticoids in a daily dose of more than or equal to 5 mg prednisone or equivalent for more than or equal to three months.

Question 9

Does pharmacologic therapy reduce fracture risk in those with low bone density?

Answer 9

Yes

Question 10

When should FDA approved medical therapies be considered in those with low bone mass?

Answer 10

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%

Question 11

Is the evidence supporting pharmacotherapy reducing fractures in patients with low bone mass but no fractures strong?

Answer 11

No

Question 12

Which term is preferred?

• osteopenia
• low bone mass
• low bone density

Answer 12

Low bone mass or low bone density

Question 13

Are people with low bone mass necessarily at high fracture risk?

Answer 13

No

Question 14

What is the preferred term for paediatric DXA reports where the Z-score is less than or equal to -2.0 Standard Deviations?

Answer 14

Low bone mass or low BMD

Question 15

Do inflammatory bowel diseases (ulcerative colitis and Crohn’s) increase the risk of low bone mass and fragility fractures?

Answer 15

Yes

Question 16

Is low bone mass indicative of future bone loss?

Answer 16

Not necessarily - it may or may not be.

Question 17

What may a Z-score of less than -1.5 be indicative of?

Answer 17

Possible secondary causes for low bone mass

Question 18

Do artifacts on DXA appear to have greater affect on BMD in patients with high or low bone density?

Answer 18

Low bone density

Question 19

Name three strong predictors of low bone mass in post-menopausal women.

Answer 19

• body weight less than 70 kg (154 lb)
• increasing age
• no current use of estrogen

Question 20

Men are generally older than women at any given level of low bone density.

True or false?

Answer 20

True

Question 21

Low bone mass can be the presenting compliant of celiac’s disease.

True or false?

Answer 21

True

Question 22

Several mast cell products have been implicated in low bone density.

True or false?

Answer 22

True

Question 23

Has an association between low bone density and cardiovascular risk been found?

Answer 23

Yes

Question 24

What three genetic defects (resulting in syndromes) are associated with low bone density in childhood?

Answer 24

• Turner’s syndrome
• Down’s syndrome
• Klinefelter’s syndrome

Question 25

Should modifiers such as mild, moderate or severe be used to describe low bone mass?

Answer 25

No

Question 26

Is the reference data for pQCT in children and adolescent sufficient for the diagnosis of low bone mass?

Answer 26

No

Question 27

What percentage of fractures occur in those with low bone mass?

Answer 27

More than 50%