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

2 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

3 Ultrasound-detected musculoskeletal urate crystal deposition: Which joints and what findings should be assessed for diagnosing gout? Annals of Rheumatic Diseases, July 14, 2014    Clinical Article

4 Adalimumab in patients with hand osteoarthritis refractory to analgesics and NSAIDs: A randomised, multicentre, double-blind, placebo-controlled trial Annals of Rheumatic Diseases, August 25, 2014    Clinical Article

5 Efficacy and safety of olokizumab in patients with rheumatoid arthritis with an inadequate response to TNF inhibitor therapy: Outcomes of a randomised Phase IIb study Annals of Rheumatic Diseases, August 12, 2014    Clinical Article

6 Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women American Journal of Clinical Nutrition, July 18, 2014    Review Article

7 Old medications and new targeted therapies in systemic sclerosis Rheumatology, August 4, 2014    Review Article

8 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

9 Non-steroidal anti-inflammatory drugs and risk of cardiovascular disease in patients with rheumatoid arthritis: A nationwide cohort study Annals of Rheumatic Diseases, July 14, 2014    Clinical Article

10 Efficacy and safety of atacicept for prevention of flares in patients with moderate-to-severe systemic lupus erythematosus (SLE): 52-week data (APRIL-SLE randomised trial) Annals of Rheumatic Diseases, August 26, 2014    Clinical Article

11 More ubiquitous effects from non-pharmacologic than from pharmacologic treatments for fibromyalgia syndrome: A meta-analysis examining six core symptoms European Journal of Pain, August 20, 2014    Review Article

12 Clinical features, treatment and outcome of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis A multinational, multicenter study of 362 patients Arthritis & Rheumatism, August 4, 2014    Clinical Article

13 Rituximab in primary Sjogren's syndrome: A ten-year journey Lupus, August 8, 2014    Clinical Article

14 Comparison of radiological and clinical results of balloon kyphoplasty according to anterior height loss in the osteoporotic vertebral fracture The Spine Journal, August 1, 2014    Clinical Article

15 Methotrexate and lung disease in rheumatoid arthritis – A meta-analysis of randomized controlled trials Arthritis & Rheumatism, December 27, 2013    Evidence Based Medicine    Review Article    Clinical Article

16 Epidemiology of primary Sjogren's syndrome: A systematic review and meta-analysis Annals of Rheumatic Diseases, August 29, 2014    Evidence Based Medicine    Review Article

17 TNF inhibitor therapy and risk of breast cancer recurrence in patients with rheumatoid arthritis: A nationwide cohort study Annals of Rheumatic Diseases, August 29, 2014    Clinical Article

18 The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: A systematic review and meta-analysis Acta Radiologica, August 22, 2014    Evidence Based Medicine    Review Article    Clinical Article

19 Low-field magnetic resonance imaging or combined ultrasonography and anti-cyclic citrullinated peptide antibody improve correct classification of individuals as established rheumatoid arthritis: results of a population-based, cross-sectional study Full Text BMC Musculoskeletal Disorders, August 8, 2014    Free full text    Evidence Based Medicine    Clinical Article

20 Sirukumab, a human anti-interleukin-6 monoclonal antibody: A randomised, 2-part (proof-of-concept and dose-finding), phase II study in patients with active rheumatoid arthritis despite methotrexate therapy Annals of Rheumatic Diseases, August 11, 2014    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