A 50-year-old man with a history of a low-trauma fracture of the distal radius is evaluated. DXA scan shows a T-score of -1.8 at the lumbar spine and -2.0 at the femoral neck. According to WHO criteria, this patient has:
- A Normal bone density
- B Osteopenia ✓
- C Osteoporosis
- D Severe (established) osteoporosis
Correct answer: B. Osteopenia
Explanation
WHO defines osteopenia as a T-score between -1.0 and -2.5. Osteoporosis is T-score -2.5 or lower. Severe osteoporosis is T-score -2.5 or lower with one or more fragility fractures. Although this patient had a fragility fracture, his T-score does not meet the -2.5 threshold for osteoporosis, so he is classified as osteopenia. The fracture history is clinically significant but does not change the DXA classification.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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