What is the interpretation of a patient's bone mineral density results showing a BMD of 0.755 g/cm² and a T-score of -0.8 for the left hip, and a BMD of 1.147 g/cm² with a T-score of -0.1 for the lumbar spine (L1-L4 levels) according to World Health Organization (WHO) criteria?

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Interpretation of Bone Mineral Density Results

Both your left hip and lumbar spine bone mineral density measurements are normal according to WHO criteria, indicating you do not have osteoporosis or osteopenia. 1

Understanding Your T-Scores

Your results demonstrate:

  • Left hip: T-score of -0.8 (BMD: 0.755 g/cm²)
  • Lumbar spine (L1-L4): T-score of -0.1 (BMD: 1.147 g/cm²)

Both T-scores are above -1.0, which definitively classifies your bone density as normal per WHO diagnostic criteria. 1, 2 The WHO establishes that normal bone mineral density requires a T-score ≥ -1.0 at any measured site. 1

WHO Classification Framework

The diagnostic categories are structured as follows:

  • Normal bone density: T-score ≥ -1.0 1, 2
  • Osteopenia (low bone mass): T-score between -1.0 and -2.5 1, 2
  • Osteoporosis: T-score ≤ -2.5 1, 2

Your diagnostic classification is based on the lowest T-score among all measured sites, which in your case is -0.8 at the left hip—still well within the normal range. 1

Clinical Significance

No pharmacological treatment for osteoporosis is indicated with your current bone density measurements. 1 The National Osteoporosis Foundation recommends pharmacologic treatment only for postmenopausal women and men >50 years with a T-score ≤ -2.5, or for those with osteopenia who have elevated fracture risk based on FRAX assessment. 1

Your fracture risk based on bone density alone is not elevated, as epidemiological studies demonstrate that fracture risk increases approximately two-fold for every standard deviation decrease below the young adult mean. 3 Your measurements are less than one standard deviation below this reference point. 3

Important Caveats

A fragility fracture would supersede these normal DXA measurements and establish an osteoporosis diagnosis regardless of T-score. 1, 2 If you experience a low-trauma fracture of the hip, spine, wrist, or proximal humerus after age 50, you should be reclassified as having osteoporosis even with normal bone density. 1

Degenerative changes in the lumbar spine can artificially elevate BMD measurements, potentially masking true bone loss. 1, 4 If you have significant facet joint osteoarthritis or spondylosis, the lumbar spine T-score may not accurately reflect your true bone health. 1

Recommended Management

Focus on non-pharmacological bone health maintenance: 4

  • Weight-bearing exercise regimen 4
  • Adequate calcium intake (1000-1200 mg/day) through diet or supplements 4, 5
  • Vitamin D supplementation (800-1000 IU/day) 4, 5
  • Smoking cessation and limited alcohol consumption 4

Repeat DXA screening intervals should follow standard guidelines based on your age, sex, and risk factors. 1 For women ≥65 years or men ≥70 years with normal baseline bone density, rescreening is typically recommended every 2-5 years, though specific timing should be determined by your clinical risk profile. 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Diagnostic Criteria for Osteoporosis Based on Bone Density

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Osteopenia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Osteoporosis Treatment Indications

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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