Question 1:

Assessment:

  • The BMD T-score fulfills the World Health Organization criteria for osteoporosis at one or more sites (T-score ≤ 2.5)
  • Compared to the prior study, there has been a statistically significant decrease in BMD at the lumbar spine and no change at the left total hip

Comments:

  • L3 and L4 were deleted from the final analysis due to presence of degenerative changes, which can falsely elevate BMD

Question 2:

Assessment:

  • The BMD T-score fulfills the World Health Organization criteria for osteoporosis at one or more sites (T-score ≤ 2.5)

Comments:

  • L3 and L4 were deleted from the final analysis due to sclerosis, which can falsely elevate BMD; correlation with x-rays is recommended

Question 3:

Assessment:

  • The BMD T-score fulfills the World Health Organization criteria for osteoporosis at one or more sites (T-score ≤ 2.5)
  • The presence of a fragility fracture makes the diagnosis of osteoporosis independent of BMD
  • Compared to the prior study, there have been no statistically significant changes in BMD at the L2-L4 spine or total hip

Comments:

  • L1 was deleted from the final analysis due to compression fracture and sclerosis which can falsely elevate BMD; correlation with x-rays is recommended

Question 4:

Assessment:

  • Normal bone density compared with age-adjusted controls
  • FRAX not reported because premenopausal woman

Comments:

  • Age changed to 20 to conform to normative data in order to obtain an approximate age-adjusted estimate

Question 5:

Assessment:

  • Osteopenia is present by BMD criteria at the spine and hip

Question 6:

Assessment:

  • Osteoporosis is present by BMD criteria at the spine and by history of fracture
  • FRAX not reported because T-score at or below -2.5 and osteoporosis by fracture criteria

Comments:

  • Noted on the BMD image was compression fracture at L2 that may falsely raise the BMD measurement. Therefore, L2 was deleted from the analysis