When Low Bone Mineral Density and Fractures Is Not Osteoporosis

Curr Osteoporos Rep. 2019 Oct;17(5):324-332. doi: 10.1007/s11914-019-00529-7.

Abstract

Purpose of review: To review the differential diagnosis of low bone mineral density (BMD).

Recent findings: Osteoporosis is the most common cause of low BMD in adults; however, non-osteoporotic causes of low BMD should be considered in the differential diagnosis of patients with low BMD. Mild osteogenesis imperfecta, osteomalacia, and mineral and bone disorder of chronic kidney disease as well as several other rare diseases can be characterized by low BMD. This review summarizes the differential diagnosis of low BMD. It is important to differentiate osteoporosis from other causes of low BMD since treatment regimens can vary tremendously between these different disease processes. In fact, some treatments for osteoporosis could worsen or exacerbate the mineral abnormalities in other causes of low BMD.

Keywords: CKD-MBD, DXA; Neurofibromatosis; Osteogenesis imperfecta; Osteomalacia; Rare diseases.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Absorptiometry, Photon
  • Bone Diseases, Metabolic / diagnosis*
  • Bone Diseases, Metabolic / etiology*
  • Diagnosis, Differential
  • Fractures, Bone / etiology*
  • Humans
  • Kidney Failure, Chronic / complications
  • Osteogenesis Imperfecta / complications
  • Osteomalacia / complications
  • Osteoporosis / diagnosis