Osteoporosis in young adults: pathophysiology, diagnosis, and management
Osteoporosis International,

Ferrari S et al. – The International Osteoporosis Foundation (IOF) convened a working group to review pathophysiology, diagnosis, and management of osteoporosis in the young, excluding children and adolescents, and provide a screening strategy including laboratory exams for a systematic approach of this condition.

  • Postmenopausal osteoporosis is mainly caused by increased bone remodeling resulting from estrogen deficiency.
  • Indications for treatment are based on low areal bone mineral density (aBMD, T–score≤–2.5), typical fragility fractures (spine or hip), and more recently, an elevated 10–year fracture probability (by FRAX).
  • In contrast, there is no clear definition of osteoporosis nor intervention thresholds in younger individuals.
  • Low aBMD in a young adult may reflect a physiologically low peak bone mass, such as in lean but otherwise healthy persons, whereas fractures commonly occur with high–impact trauma, i.e., without bone fragility.
  • Furthermore, low aBMD associated with vitamin D deficiency may be highly prevalent in some regions of the world.
  • Nevertheless, true osteoporosis in the young can occur, which the authors define as a T–score below -2.5 at spine or hip in association with a chronic disease known to affect bone metabolism.
  • In the absence of secondary causes, the presence of fragility fractures, such as in vertebrae, may point towards genetic or idiopathic osteoporosis. In turn, treatment of the underlying condition may improve bone mass as well.
  • In rare cases, a bone–specific treatment may be indicated, although evidence is scarce for a true benefit on fracture risk.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Rheumatology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Rheumatology Articles

1 Homeopathy in the treatment of fibromyalgia- A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, August 15, 2014    Evidence Based Medicine    Review Article

2 Coffee or tea consumption and the risk of rheumatoid arthritis: A meta-analysis Clinical Rheumatology, October 15, 2014    Clinical Article

3 The comparative safety of TNF inhibitors in rheumatoid arthritis - a meta-analysis update of 44 randomized controlled trials American Journal of Medicine, October 6, 2014    Clinical Article

4 Drug-associated cutaneous vasculitis: Study of 239 patients from a single referral center The Journal of Rheumatology, September 25, 2014    Clinical Article

5 Rituximab for the treatment of relapses in ANCA-associated vasculitis Arthritis & Rheumatism, August 1, 2014    Clinical Article

6 Lupus classification criteria expanded; treat-to-target approach gains support Full Text The Rheumatologist, July 24, 2014    Free full text

7 Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis Arthritis Research & Therapy, October 8, 2014    Evidence Based Medicine    Review Article

8 The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: A meta-analysis Clinical and Experimental Rheumatology Online, October 27, 2014    Evidence Based Medicine    Clinical Article

9 Efficacy and safety of ginger in osteoarthritis patients: A meta-analysis of randomized placebo-controlled trials Osteoarthritis and Cartilage , October 28, 2014    Evidence Based Medicine    Clinical Article

10 Early predictors of prognosis in juvenile idiopathic arthritis: A systematic literature review Annals of Rheumatic Diseases, August 29, 2014    Review Article

11 Homeopathy in the treatment of fibromyalgia—A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, October 9, 2014    Clinical Article

12 Alcohol consumption as a preventive factor for developing rheumatoid arthritis: A dose-response meta-analysis of prospective studies Annals of Rheumatic Diseases, October 24, 2014    Evidence Based Medicine    Clinical Article

13 Cost-utility of cognitive behavioural therapy versus U.S. food and drug administration recommended drugs and usual care in the treatment of patients with fibromyalgia: An economic evaluation alongside a 6-month randomised controlled trial Arthritis Research & Therapy, October 7, 2014    Clinical Article

14 Baseline serum level of matrix metalloproteinase-3 as a biomarker of progressive joint damage in rheumatoid arthritis patients International Journal of Rheumatic Diseases, October 17, 2014    Clinical Article

15 Targeted treatment with a combination of traditional DMARDs produces excellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regardless of initial infliximab: The 5-year follow-up results of a randomised clinical trial, the NEO-RACo trial Annals of Rheumatic Diseases, October 23, 2014    Clinical Article

16 Low-dose pulse cyclophosphamide in interstitial lung disease associated with systemic sclerosis (SSc-ILD) - efficacy of maintenance immunosuppression in responders and non-responders Seminars in Arthritis and Rheumatism, September 30, 2014    Clinical Article

17 Vitamin D deficiency is associated with progression of knee osteoarthritis The Journal of Nutrition, October 10, 2014    Clinical Article

18 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 14, 2014    Clinical Article

19 Lipid profile changes in patients with chronic inflammatory arthritis treated with biologics and tofacitinib in randomized clinical trials: A systematic review and meta-analysis Arthritis & Rheumatism, October 14, 2014    Evidence Based Medicine    Review Article

20 Efficacy of a natural mineral complex in North American adults with osteoarthritis of the knee: A randomized double-blind placebo-controlled study Full Text Open Access Rheumatology: Research and Reviews, October 13, 2014    Free full text    Clinical Article

Indexed Journals in Rheumatology: Arthritis & Rheumatism, Annals of Rheumatic Diseases, Journal of Rheumatologymore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close