Friend or foe: high bone mineral density on routine bone density scanning, a review of causes and management
Identifieur interne : 005656 ( Ncbi/Checkpoint ); précédent : 005655; suivant : 005657Friend or foe: high bone mineral density on routine bone density scanning, a review of causes and management
Auteurs : Celia L. Gregson [Royaume-Uni] ; Sarah A. Hardcastle ; Cyrus Cooper [Royaume-Uni] ; Jonathan H. TobiasSource :
- Rheumatology (Oxford, England) [ 1462-0324 ] ; 2013.
Abstract
A finding of high BMD on routine DXA scanning is not infrequent and most commonly reflects degenerative disease. However, BMD increases may also arise secondary to a range of underlying disorders affecting the skeleton. Although low BMD increases fracture risk, the converse may not hold for high BMD, since elevated BMD may occur in conditions where fracture risk is increased, unaffected or reduced. Here we outline a classification for the causes of raised BMD, based on identification of focal or generalized BMD changes, and discuss an approach to guide appropriate investigation by clinicians after careful interpretation of DXA scan findings within the context of the clinical history. We will also review the mild skeletal dysplasia associated with the currently unexplained high bone mass phenotype and discuss recent advances in osteoporosis therapies arising from improved understanding of rare inherited high BMD disorders.
Url:
DOI: 10.1093/rheumatology/ket007
PubMed: 23445662
PubMed Central: 3651616
Affiliations:
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Gregson</name><affiliation><nlm:aff wicri:cut=" and" id="ket007-AFF1">Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol</nlm:aff><wicri:noCountry code="subfield">Bristol</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="ket007-AFF1">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Hardcastle, Sarah A" sort="Hardcastle, Sarah A" uniqKey="Hardcastle S" first="Sarah A." last="Hardcastle">Sarah A. 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Gregson</name><affiliation><nlm:aff wicri:cut=" and" id="ket007-AFF1">Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol</nlm:aff><wicri:noCountry code="subfield">Bristol</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="ket007-AFF1">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Hardcastle, Sarah A" sort="Hardcastle, Sarah A" uniqKey="Hardcastle S" first="Sarah A." last="Hardcastle">Sarah A. Hardcastle</name><affiliation><nlm:aff wicri:cut=" and" id="ket007-AFF1">Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol</nlm:aff><wicri:noCountry code="subfield">Bristol</wicri:noCountry></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation wicri:level="1"><nlm:aff id="ket007-AFF1">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Tobias, Jonathan H" sort="Tobias, Jonathan H" uniqKey="Tobias J" first="Jonathan H." last="Tobias">Jonathan H. Tobias</name><affiliation><nlm:aff wicri:cut=" and" id="ket007-AFF1">Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol</nlm:aff><wicri:noCountry code="subfield">Bristol</wicri:noCountry></affiliation></author></analytic><series><title level="j">Rheumatology (Oxford, England)</title><idno type="ISSN">1462-0324</idno><idno type="eISSN">1462-0332</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A finding of high BMD on routine DXA scanning is not infrequent and most commonly reflects degenerative disease. However, BMD increases may also arise secondary to a range of underlying disorders affecting the skeleton. Although low BMD increases fracture risk, the converse may not hold for high BMD, since elevated BMD may occur in conditions where fracture risk is increased, unaffected or reduced. Here we outline a classification for the causes of raised BMD, based on identification of focal or generalized BMD changes, and discuss an approach to guide appropriate investigation by clinicians after careful interpretation of DXA scan findings within the context of the clinical history. We will also review the mild skeletal dysplasia associated with the currently unexplained high bone mass phenotype and discuss recent advances in osteoporosis therapies arising from improved understanding of rare inherited high BMD disorders.</p></div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><noCountry><name sortKey="Hardcastle, Sarah A" sort="Hardcastle, Sarah A" uniqKey="Hardcastle S" first="Sarah A." last="Hardcastle">Sarah A. Hardcastle</name><name sortKey="Tobias, Jonathan H" sort="Tobias, Jonathan H" uniqKey="Tobias J" first="Jonathan H." last="Tobias">Jonathan H. Tobias</name></noCountry><country name="Royaume-Uni"><noRegion><name sortKey="Gregson, Celia L" sort="Gregson, Celia L" uniqKey="Gregson C" first="Celia L." last="Gregson">Celia L. Gregson</name></noRegion><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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