Misinterpretation of osteodensitometry with high bone density: BMD Z > or = + 2.5 is not "normal".
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.
Whyte
Michael P
MP
Division of Bone and Mineral Diseases, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO 63110, USA. mwhyte@shrinenet.org
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D005260:Female; D006801:Humans; D026502:LDL-Receptor Related Proteins / Q000235:genetics*; D060492:Low Density Lipoprotein Receptor-Related Protein-5; D009154:Mutation; D010024:Osteoporosis / Q000175:diagnosis*
D026502:LDL-Receptor Related Proteins; C555482:LRP5 protein, human; D060492:Low Density Lipoprotein Receptor-Related Protein-5