osteopenia

Last edited 11/2020 and last reviewed 01/2023

Osteopenia is defined as a reduction in bone density.

The term is often used radiologically when it describes a qualitative appearance of bone on a radiograph.

Increasingly however the term refers to a quantitative loss of bone mineral density usually measured either at the hip or spine with dual energy X ray aborptiometry.

Osteopaenia is defined when bone density at the spine or hip between 1.0 and 2.5 standard deviations below the average for healthy young adults (T-score between -1 and -2.5).

Osteoporosis is defined if the T-score is more than 2.5 standard deviations below the average.

Normal bone mineral density is : T-score of -1 standard deviations or above

Management:

• lifestyle advice
  • balanced diet including adequate calcium and vitamin D
  • regular weight-bearing exercise eg. walking, dancing, skipping, gym
  • stop smoking
  • reduce alcohol intake
    
    
• zoledronic acid may be considered to reduce risk of clinical fractures in women over 65 years of age who have osteopenia at hip or femoral neck on DXA (2)
  
  
• patients with osteopenia (t score -1 to -2.5) should be re- scanned in 3 years

Reference:

• Wirral University Hospital NHS Foundation Trust. Wirral guidelines for the management of osteoporosis.
• SIGN (June 2020). Management of osteoporosis and the prevention of fragility fractures