Criteria
T-scores for classification of osteoporosis
A T-score is the number of standard deviations above or below the bone mineral density (BMD) mean for young, healthy white women.
A World Health Organization study group proposed four categories for T-scores:[3]
Normal: T-score ≥-1 (within 1 standard deviation of young, healthy white women)
Osteopenia: T-score <-1 but >-2.5
Osteoporosis: T-score of ≤-2.5
Severe (or established) osteoporosis: T-score ≤-2.5 with fragility fracture(s)
American College of Rheumatology fracture risk criteria for corticosteroid induced osteoporosis[87]
Very high
Adults ≥40 years of age - very high risk
Prior osteoporotic fracture(s) OR BMD T score ≤ -3.5 OR FRAX® (GCAdjusted*) 10-year risk of major osteoporotic fracture (MOF) ≥30% or hip ≥4.5% OR high glucocorticoid (GC) prednisolone dose ≥30 mg/day for >30 days OR cumulative GC prednisolone doses ≥5 g/year
Major osteoporotic fractures are non-traumatic or pathological fractures of the spine, hip, wrist, or humerus
Adults <40 years of age
Prior fracture(s) OR GC ≥30 mg/day OR cumulative ≥5 g/year
High
Adults ≥40 years of age
BMD T score ≤ -2.5 but > -3.5 OR FRAX® (GC-Adjusted*) 10-year risk of MOF ≥20% but <30% or hip ≥3% but <4.5%
Moderate
Adults ≥40 years of age
FRAX® (GC-Adjusted) 10-year risk of MOF ≥10 and <20%, hip >1 and <3% OR BMD T score between -1 and -2.4
Adults <40 years of age
Continuing GC treatment ≥7.5 mg/day for ≥6 months AND BMD Z score < -3 OR significant BMD loss (> least significant change of DXA)
Low
Adults ≥40 years of age
FRAX® (GC-Adjusted) 10-year risk of MOF <10%, hip <1 %, BMD > -1.0
Adults <40 years of age
None of the above risk factors other than GC treatment
Use of this content is subject to our disclaimer