A patient has a T-score of -1.8 on DEXA. What is the diagnosis?

• A. Osteopenia
• B. Osteoporosis
• C. Normal bone density
• D. Severe osteoporosis

Answer: (A)

Understanding how a DEXA T-score is interpreted is key here. The T-score compares your bone mineral density to the mean density of a healthy young adult, expressed in standard deviations from that mean. Thresholds are: normal density is -1.0 or higher; osteopenia is between -1.0 and -2.5; osteoporosis is -2.5 or lower. A T-score of -1.8 falls in the osteopenia range, meaning bone density is below normal but not low enough to be called osteoporosis. This indicates a higher fracture risk than normal and guides risk-based management, with options ranging from lifestyle modifications to pharmacologic therapy depending on overall fracture risk and other factors. The Z-score, by contrast, compares to someone of the same age and isn’t used to diagnose osteoporosis.