Misinterpretation of osteodensitometry with high bone density: BMD Z > or = + 2.5 is not "normal"

J Clin Densitom. 2005 Spring;8(1):1-6. doi: 10.1385/jcd:8:1:001.

Abstract

Osteodensitometry is increasingly used to identify low bone density resulting from osteoporosis. The universally accepted World Health Organization (WHO) criteria for assessing bone mineral density (BMD) contrasts individual T-scores to peak BMD in healthy adult control populations. In this scheme, "osteoporosis" refers arbitrarily to T-values below -2.5, "osteopenia" to values between -1.0 and -2.5, and "normal" to values above -1.0. Although individually rare, numerous conditions cause supranormal BMD in children and adults. Increasingly, elevated BMD is detected by osteodensitometry, especially dual-energy X-ray absorptiometry. Illustrated here, the absence of upper limits for BMD in the WHO criteria jeopardizes recognition of high-BMD disease for all age groups. This oversight requires correction using Z-scores.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon*
  • Adult
  • Bone Density*
  • Female
  • Humans
  • LDL-Receptor Related Proteins / genetics*
  • Low Density Lipoprotein Receptor-Related Protein-5
  • Mutation
  • Osteoporosis / diagnosis*

Substances

  • LDL-Receptor Related Proteins
  • LRP5 protein, human
  • Low Density Lipoprotein Receptor-Related Protein-5