osteoporosis" and "osteoporosis".
Correctly recognize their similarities and differences.
I often have patients come to me with a CT report of the skeleton, saying that they have osteoporosis (as shown in Figure 1), and ask if they can use bisphosphonates or other anti-osteoporotic drugs.
I tend to say that "osteoporosis" is not "osteoporosis" and that further tests are needed to confirm the diagnosis of "osteoporosis" before these drugs can be considered.
Figure 1"Osteoporosis" report sheet (** on the Internet).
osteoporosis
We often refer to "osteoporosis" as "osteoporosis", but the two are not the same, and what are the differences between them, which is briefly explained below.
1.The concept is different.
"Osteoporosis" is a manifestation that reflects only local changes in the bones;Osteoporosis is a systemic bone disease characterized by low bone mass and damage to the microstructure of bone tissue, resulting in increased bone fragility and prone to fractures.
For example, if the human body is a house, then the bones are bricks. "Osteoporosis" refers to a local phenomenon reflected by the lack of strong bricks in a certain corner of the house;"Osteoporosis" is the fact that the bricks of the whole house are not strong, reflecting an overall disease.
Therefore, you can't look at the leopard in the tube, and the local "osteoporosis" is not the overall "osteoporosis".
2.The age and location of onset are different.
"Osteoporosis" can occur at any age and gender, such as prolonged immobilization after a fracture, which can lead to osteoporosis of the local bones, and "osteoporosis" is more common in postmenopausal women and men over 70 years old.
In addition, "osteoporosis" generally refers to the "porosity" of cortical bone;"Osteoporosis" is mainly the "loosening" of cancellous bone.
3.The diagnosis is different.
"Osteoporosis" is mainly judged by imaging manifestations, and the diagnosis of "osteoporosis" can be considered when CT or X-ray shows the thinning of the trabecular bone, the widening of the trabecular space, and the thinning of the bone cortex.
The diagnosis of "osteoporosis" requires a combination of dual-energy X-ray (DXA) or quantitative CT (QCT) to determine the bone mineral density value, and combined with the history of previous fragility fractures.
Figure 2Classification criteria for bone mineral density measurement based on DXA (2022 guidelines for the diagnosis and treatment of primary osteoporosis).
Figure 3Diagnostic criteria for osteoporosis (2022 guidelines for the diagnosis and treatment of primary osteoporosis).
Summary. Although "osteoporosis" is often referred to as "osteoporosis", there is a difference in its meaning, and "osteoporosis" seen on imaging examination does not indicate the presence of "osteoporosis";Patients with a confirmed diagnosis of "osteoporosis" may also not have "osteoporosis". Only patients with a definite diagnosis of "osteoporosis" need to consider anti-osteoporosis**.