Osteopenia

  • Medical Author:
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Osteoporosis Pictures Slideshow: Are Your Bones at Risk?

Osteopenia vs. osteoporosis

Osteopenia and osteoporosis are related conditions. The difference between osteopenia and osteoporosis is that in osteopenia the bone loss is not as severe as in osteoporosis. That means someone with osteopenia is more likely to fracture a bone than someone with a normal bone density but is less likely to fracture a bone than someone with osteoporosis.

What risk factors and causes of osteopenia?

Osteopenia has multiple causes. Common causes and risk factors include

  • genetics (familial predisposition to osteopenia or osteoporosis, a family history of early bone loss, and other genetic disorders);
  • hormonal causes, including decreased estrogen (such as in women after menopause) or testosterone;
  • smoking;
  • excess alcohol;
  • thin frame;
  • immobility;
  • certain medications (such as corticosteroids, including prednisone) and antiseizure medications;
  • malabsorption due to conditions (such as celiac sprue);
  • and chronic inflammation due to medical conditions (such as rheumatoid arthritis).

What are osteopenia symptoms and signs?

Osteopenia does not cause pain unless a bone is broken (fractured). Interestingly, fractures in patients with osteopenia do not always cause pain. Osteopenia or osteoporosis can be present for many years prior to diagnosis for these reasons. Many bone fractures due to osteopenia or osteoporosis, such as a hip fracture or vertebral fracture (fracture of a bone in the spine), are very painful. However, some fractures, especially vertebral fractures (fractures of the bony building blocks of the spine), can be painless and therefore osteopenia or osteoporosis may go undiagnosed for years.

Why is osteopenia important?

Osteopenia is important because it can cause bone fractures. People with osteopenia are not as likely to fracture a bone as those with osteoporosis; however, because there are many more people with osteopenia than osteoporosis, patients with osteopenia account for a large number of patients who fracture a bone. In other words, while osteoporosis indicates bone that is more prone to fracture and people with osteoporosis have a higher percentage risk of fracture than osteopenia, because of the much larger number of people with osteopenia there is a greater total number of fractures in these people.

Bone fractures due to osteopenia and osteoporosis are important because they can be very painful, although some spinal (vertebral) fractures are painless.

In addition to the pain, hip fractures are a serious problem because they require surgical repair. Also, many patients require long-term nursing-home care after a hip fracture. Fractures, especially in the elderly, are associated with an increase in overall mortality (death rate). A significant percentage of people die in the year following hip fracture, due to complications including blood clots related to immobility, pneumonia, and many other reasons.

Medically Reviewed by a Doctor on 3/4/2016

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