The World Health Organization (WHO) has set guidelines for characterizing the degree of bone loss. In order to do so, bone density must be compared with what is typically seen in younger people. Osteopenia is a level of bone density reduction that places a person at greater risk of fracture. It is said to be a measured bone density that is 1 to 2.5 standard deviations (a measure of statistical variability) below an average (or statistical mean) for a younger person of the same gender. Osteoporosis is more severe, whereby the reduction of bone density is greater than 2.5 standard deviations below the average. Individuals should talk to their physicians about where they are relative to others and X-ray measurements such as DXA (dual energy X-ray absorptiometry, see Chapter 8) are used in the diagnosis. Generally, osteoporosis develops without symptoms. It is usually not until a person fractures a bone or complains of severe back pain that an X-ray diagnosis is made.
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