Osteopenia is a bone condition characterized by a decrease in bone mineral density (BMD) which results in bone weakness and increased risk of bone fracture. Both osteopenia and osteoporosis are related conditions, where the latter is more severe and is characterized by more loss in BMD.
Common causes responsible for the development of osteopenia are genetic factors, decreased levels of hormones such as estrogen in women after menopause and testosterone in men, and also chronic inflammation caused by certain disease such as rheumatoid arthritis. Other possible causes for osteopenia are exposure to radiation, eating disorders, smoking, excessive alcohol consumption, and taking certain medications such as anti-epileptic and steroid medicines.
Pain is not felt with osteopenia unless a bone fracture occurs therefore osteopenia and osteoporosis can remain undiagnosed for many years. Osteopenia is responsible for bones fractures such as hip or vertebral fractures which are very painful and can produce serious problems, especially in the elderly, as surgery is usually required to treat the fracture and may increase their mortality rate.
The osteopenia condition can be diagnosed by measuring the bone mineral density (BMD) of the hip, spine, and sometimes wrist, as these are the frequent sites of bone fracture. The dual energy X-ray absorptiometry scan or DXA scan (earlier known as DEXA scan) is recommended, which can accurately predict the risk of future fracture. The results of DXA scan are given in the form of “T score” and “Z score”. The Z score compares the patient’s BMD with the average value of the person of the same age and sex, while T score compares BMD with a healthy 30-year old person of the same sex.
In most of the cases, T score between -1.0 and -2.5 indicate osteopenia where as T score lower than -2.5 indicates osteoporosis.
Other tests which are employed for measuring bone density are peripheral dual-energy X-ray absorptiometry (pDXA), quantitative computed tomography (QCT), peripheral QCT (pQCT), and quantitative ultrasound densitometry (QUS). Sometimes routine X-rays are also useful in diagnosing conditions such as diffuse osteopenia and spine osteopenia.
These tests are recommended for specific groups of people such as men and women above 65 years or older, postmenopausal women between 50-69 years, and also for adults with history of fracture after 50 years of age or suffering from disease condition such as rheumatoid arthritis or taking steroid medication.
People with osteopenia should modify their lifestyle by performing weight bearing exercises and avoiding smoking and alcohol consumption. In addition, medications such as calcium and vitamin D are also prescribed and patients are encouraged to eat more foods with calcium and vitamin D such as milk, cheese, and yogurt.
