Osteopenia - Overview
How is osteopenia diagnosed?
Osteopenia is diagnosed with a
bone density test, usually done to see whether you have
osteoporosis. The most accurate test of bone density is dual-energy X-ray absorptiometry
(DXA), although there are other methods. DXA is a form of X-ray that can
detect as little as 2% of bone loss per year. A standard X-ray is not useful in
diagnosing osteopenia, because it is not sensitive enough to detect small
amounts of bone loss or minor changes in bone density. See the topic
Osteoporosis for more information on bone density testing.
United States Preventive Services Task Force
(USPSTF) recommends that all women age 65 and older routinely have a
bone density test to screen for osteoporosis.
If you are at increased risk for fractures caused by osteoporosis, routine
screening should begin sooner.1 USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.
The FRAX tool was developed by the World Health Organization to help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone density test on your hip, you can type in your score. If you have not had that test, you can leave the score blank.
Things that increase risk include:
- Being white (Caucasian) or, to a lesser degree,
- A family history of osteoporosis.
- Long-term use of corticosteroids, such as hydrocortisone or
prednisone for inflammatory conditions, or anticonvulsants, such as
carbamazepine (Tegretol), gabapentin (Neurontin), or phenytoin (Dilantin) for
pain or seizures.
- Eating disorders or diseases that affect the
absorption of nutrients from food.
- Being inactive or bedridden for
a long period of time.
- Drinking excessive
amounts of alcohol.
- Having a diet low in
Information for men. Experts suggest that older men talk to their doctors about osteoporosis and, if they are at risk, have bone density tests done.2
Many men don't think they are at risk for osteopenia or osteoporosis, since
these are commonly considered to be conditions of older women. Because men have
a higher peak bone density than women at middle age, osteopenia and
osteoporosis tend to happen at an older age in men. But aside from the hormonal
change in women as they go through menopause, the things that put people at risk for osteopenia
are true for men as well as for women. Men are also at risk if they have low
levels of the hormone testosterone. Talk with your doctor if any risk factors
apply to you.