Decreased Bone Density
February 15th, 2021
Generalised Osteopaenia
Look for a reduction in bone density, either generally or surrounding a joint.
Generalised osteopaenia suggests an imbalance in bone deposition and resorption, placing bone at risk of pathological fractures.
Causes of Generalised Osteopaenia
- Post-menopausal
- Senile (age-related)
- Genetic - osteogenesis imperfecta
- Metabolic - hyperparathyroidism, hypogonadism, hyperthyroidism, Cushing's disease, Addison's disease, vitamin D deficiency, ESRF, paraneoplastic syndrome, T1DM, acromegaly
- Malnutrition - eating disorder, poor intake
- Malabsorption - coeliac disease, IBD, pancreatic insufficiency
- Hepatic - chronic hepatitis, alcoholic liver disease, biliary cirrhosis
- Marrow failure - leukaemia / lymphoma, multiple myeloma, thalassaemia, sickle cell anaemia, haemochromatosis, amyloidosis, sarcoidosis
- Transplant - marrow, heart, lung, liver, kidney
- Medications - corticosteroids, chemotherapy drugs, anticonvulsants, PPIs, SSRIs, lithium, aluminium
On a plain x-ray it is not possible to distinguish between osteopaenia and osteoporosis.
Periarticular Osteopaenia
Look For
- Loss of bone density surrounding joints.
Causes of Periarticular Osteopaenia
- Rheumatoid arthritis
- Chronic joint disuse
- Early Paget's disease
Lytic Lesions
Look For
- Focal areas of bony hypodensity.
Significance
- Classically a sign of multiple myeloma.
Causes of Lytic Lesions
FOG MACHINES- Fibrous dysplasia
- Osteoblastoma
- Giant cell tumor
- Metastasis / multiple myeloma
- Aneurysmal bone cyst
- Chondroblastoma
- Hyperparathyroidism (brown tumour) / haemangioma
- Infection (osteomyelitis)
- Nonossifying fibroma
- Eosinophilic Granuloma
- Solitary Bone Cyst
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------