Screening techniques developed for poorly understood osteoporosis in young adults

Researchers from the International Osteoporosis Foundation have published pathophysiology, diagnosis and management screening strategies in a review published in Osteoporosis International.

“The clinical relevance of low bone mineral density in young adults is less well understood than is the case in postmenopausal women and older men,” Cyrus Cooper, chair of the International Osteoporosis Foundation, stated in a news release. “Furthermore, many treatment modalities licensed for use in postmenopausal osteoporosis have not been carefully evaluated in younger adults. Clear guidance as to the interpretation of bone mineral density and the appropriate use of treatments is therefore most timely.”

The authors that skeletal fragility in young adults may not indicate osteoporosis since 30% to 50% of young adults have had fractures during childhood or adolescence. The investigators stated low areal bone mineral density (aBMD) may indicate low peak bone mass in young adults. The authors noted aBMD less than 2.5 must be analyzed with caution in patients of small body size or stunted growth. An incorrect diagnosis could lead to unnecessary prescriptions, patient anxiety and revocation of insurance benefits in some countries. However, low aBMD combined with uncommon fracture types, such as low trauma, multiple or vertebral fractures, should be interpreted with caution, the authors noted.

Bisphosphonates may aid young patients, but its effectiveness in young adults has not been documented in the literature. The authors suggested the restriction of antiresporptive medications where there is no evidence of secondary causes, multiple or vertebral fractures, high bone turnover and bone loss.

Reference:

Ferrari S, Bianchi ML, Eisman JA. Osteoporosis in young adults: pathophysiology, diagnosis, and management. Osteoporos Int. Published online ahead of print June 9, 2012.