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Testing For and Diagnosis of Osteopenia

What is Osteopenia and Who Gets It?

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Updated January 29, 2009

Bones - Foot Bones

X-ray of A Foot

Photo: Sami Sarkis / Getty Images
Osteopenia is a medical condition in which bone mineral density is low. Recently, a colleague (who was diagnosed as having osteopenia) asked me about treatment and medications. I didn’t have the information off the top of my head, but I told her (confidently) “Oh, I’ll just do a few searches on osteopenia and I’ll send you the information.” I was very wrong. For some reason, information on osteopenia (which is more and more frequently diagnosed) is really hard to find. Osteopenia usually shows up as a footnote in entries about osteoporosis. So I decided I would just have to write my own article about osteopenia (read more about osteopenia medications and osteopenia prevention).

Diagnosis of Osteopenia

Osteopenia is an age-related condition in which the bone mineral density is lower than usual. In most people, osteopenia is considered an “early warning” for osteoporosis (which is defined as bone mineral density 2.5 standard deviations less than peak bone mineral density –- that’s a fancy way of saying “really low bone mineral density”). When the bone mineral density is between 1 and 2.5 standard deviations less (which is to say low, but not really low), then a person is said to have osteopenia. People with osteopenia are at risk for developing osteoporosis and there is a good deal of controversy when (or if) treatment for improving bone density should occur in people with osteopenia. Osteopenia is a “silent” condition. People with osteopenia have no symptoms.

Testing for Osteopenia

Osteopenia (and osteroporsis) can be tested using a variety of techniques. Bone scans (X-ray) can tell the density of bones and there are X-ray machines that are portable and often used in health screenings to look for osteopenia or osteoporosis. Testing is painless and quick.

Screening Guidelines

According to the U.S. Preventive Services Task Forces, bone mineral density screens are recommended for all women aged 65 or older and for women 60 and older if they are:
  • white or Asian
  • have a family history of osteoporosis
  • thin or petite
  • have long-term history of using steroids for treating medical conditions
  • smokers
  • have low vitamin D or calcium

Who Has Osteopenia?

Women mostly. This is because of rapid bone density loss during the first year or two after menopause (as all those hormones and chemicals in the body reset). This bone loss often stabilizes after the initial period. Some estimates say that up to 18 million women have osteopenia (with another 10 million havin osteoporosis). Other risk factors for osteopenia are lack of exercise (your bones need some stimulation to stay healthy), smoking, excessive alcohol and long-term use of some medications (like steroids). Some loss of bone density is normal with aging and osteopenia itself may simply be the normal aging of bones (it doesn’t really pose a problem unless it becomes osteoporosis).

Read More About Osteopenia

Sources:

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Feb. 2008. Accessed July 23, 2008.

MedlinePlus Medical Encyclopedia: Osteoporosis

Osteopenia. Sundeep Khosla, M.D., and L. Joseph Melton, III, M.D., M.P.H. New England Journal of Medicine. Volume 356:2293-2300. May 31, 2007.

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. 2008.

MedlinePlus Medical Encyclopedia: Bone mineral density test.

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