Osteoporosis classification scheme

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]

Overview

Osteoporosis is defined as a disease state with a T-score of less than -2.5 for decreased bone mineral density on a DEXA scan. Osteoporosis may be primary (without any underlying cause) or secondary (having an underlying cause).

Classification

There are three types into which osteoporosis is sub-divided. They are:

• Involutional Osteoporosis - otherwise called primary osteoporosis. No underlying cause is identified.
• Secondary osteoporosis in which the underlying cause (eg, steroid use) is known.
• Rare forms of the disease, such as juvenile, pregnancy-related, and postpartum osteoporosis.

There is a spectrum of disease ranging from osteopenia (milder and earlier bone loss) to osteoporosis (later more severe bone loss).

Osteopenia

Osteopenia which is defined as bone mineral density ranging from less than -1.0 and more than -2.5, can be a precursor condition to osteoporosis.

Osteoporosis

In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old sex-matched healthy person average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.