Difference Between Osteopenia and Osteoporosis

Osteoporosis is a disease while osteopenia is low bone density, which is a known feature of osteoporosis. This article will talk about both Osteopenia and Osteoporosis and the differences between them in detail, highlighting their clinical features, symptoms, causes, tests and diagnosis, prognosis, and also the course of treatment and prevention of osteoporosis.

What is Osteoporosis?

Osteoporosis is a disease which weakens our bones, breaks down organic and inorganic tissues in them and makes them more likely to break under stress. Osteoporosis means hollow bones or porous bones. Osteoporosis does not cause overt symptoms at the onset, but progresses silently until the bones break. Although bones appear as hard inanimate structures, they are, in fact, made up of living cells. These cells secrete the hard inorganic mineral matrix giving bone the resilience to withstand stress. In the womb, only some bones are hard, and there is much movement between adjacent bones to support vaginal birth. During childhood more bone tissue forms to allow growth. There are growth spurts in early childhood and puberty. By about 30 years of age, the skeleton reaches its lifetime best. The mass of bone during this period is called the “peak bone mass”.  After this age, the rate of bone formation is equal to the rate of bone breakdown. Bone is said to remain in equilibrium during this period. This stage lasts till about 50 to 60 years of age in females and males respectively. Then the rate of bone breakdown exceeds the rate of bone formation. This leads to osteoporosis.

44 million Americans suffer from osteoporosis according to the World Health Organization. 80% of that 44 million are women after menopause. Osteoporosis leads to hip fractures. Hip fractures are a very common consequence of osteoporosis which results in permanent disability and poor quality of life. Rate of healing of hip fractures is slow due to poor bone formation, nutritional problems, infections, and other drugs the patient might be on.

Prevention of osteoporosis is definitely better than cure in this case because there is no effective way to cure osteoporosis. Preventive measures include dietary supplementation of calcium, phosphates, and other minerals and stopping bone degrading drugs. Incidence of osteoporosis rises sharply in women after menopause due to lack of estrogen.

Hormone replacement therapy slows down the progression of osteoporosis dramatically, but it is not advisable as a long term solution because of the associated high risk of malignancy.

What is Osteopenia?

Osteopenia is low bone density. The diagnosis needs evidence. Good X-ray films show signs of low bone density. X rays penetrate bone easier if bone density is low. There are special tests to detect low bone density. Signs in initial x rays indicate the need for further evaluation. Bone density scans produce results in the form of T score. T score represents the standard deviation of your score from that of a healthy young adult male. Bone mass varies from person to person. Genetics, height and weight of parents, environmental factors such as nutrition, hormonal changes, and diseases influence the peak bone mass. Some individuals may have a low bone density as their norm. Therefore, bone density itself cannot predict the likelihood of a fracture. However, low bone density can be used as an indicator to start nutritional supplementation and stop drugs that contribute towards low bone density.

What is the difference between Osteopenia and Osteoporosis?

• Osteoporosis is a disease of bone loss. Osteopenia is low bone density.

• The cause of osteoporosis is due to bone breakdown overwhelming bone formation. The cause of osteopenia is due to impaired bone formation.


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