The French multicentre elevated bone mass study: prevalence and causes
- 2 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Osteoporosis International
- Vol. 32 (9), 1763-1775
- https://doi.org/10.1007/s00198-021-05898-3
Abstract
The purpose of this multicentric study was to evaluate the prevalence and causes of Elevated Bone Mass (EBM) in patients who underwent DXA scanning over a 10-year period. The prevalence of EBM was 1 in 100. The main causes of EBM were degenerative spine disorders and renal osteodystrophy. Reports of elevated bone mass (EBM) on routine dual energy X-Ray absorptiometry (DXA) scanning are not infrequent. However, epidemiological studies of EBM are few and definition thresholds are variable. The purpose of this French multicentric study was to evaluate the prevalence and causes of EBM in adult patients who underwent DXA scanning over a 10-year period. This multicentric, retrospective study was conducted in six French regional bone centres. DXA databases were initially searched for individuals with a bone mineral density (BMD) Z-score ≥ +4 at any site in the lumbar spine or hip from April 1st, 2008 to April 30st, 2018. In all, 72,225 patients with at least one DXA scan were identified. Of these, 909 (322 men and 587 women) had a Z-score ≥ + 4, i.e. a prevalence of 1.26% [1.18–1.34%]. The DXA scan reports and imagery and medical records of the 909 EBM patients were reviewed and 936 causes were found. In 42 patients (4%), no cause could be determined due to unavailability of data. Artefactual causes of EBM were found in 752 patients (80%), in whom the predominant cause was degenerative disease of the spine (613 patients, 65%). Acquired causes of focal EBM—including Paget’s disease (n = 7)—were found in 12 patients (1%), and acquired causes of generalized EBM—including renal osteodystrophy (n = 32), haematological disorders (n = 20) and hypoparathyroidism (n = 15)—in 84 patients (9%). Other causes were rare hereditary diseases and unknown EBM in 19 (2%) and 27 (3%) cases respectively. The prevalence of EBM was approximately 1 in 100. These findings suggest that degenerative disease of the spine is the main cause of EBM, but that acquired or hereditary diseases are also causal factors.Keywords
This publication has 36 references indexed in Scilit:
- Friend or foe: high bone mineral density on routine bone density scanning, a review of causes and managementRheumatology, 2013
- Revised Reference Curves for Bone Mineral Content and Areal Bone Mineral Density According to Age and Sex for Black and Non-Black Children: Results of the Bone Mineral Density in Childhood StudyJournal of Clinical Endocrinology & Metabolism, 2011
- ‘Sink or swim’: an evaluation of the clinical characteristics of individuals with high bone massOsteoporosis International, 2011
- Relative value of the lumbar spine and hip bone mineral density and bone turnover markers in men with ankylosing spondylitisClinical Rheumatology, 2011
- Systemic mastocytosis and bone involvement in a cohort of 75 patientsAnnals Of The Rheumatic Diseases, 2010
- Dynamic and Structural Properties of the Skeleton in HypoparathyroidismJournal of Bone and Mineral Research, 2008
- Identification of a 52 kb deletion downstream of the SOST gene in patients with van Buchem diseaseJournal of Medical Genetics, 2002
- Further Evidence for Genetic Heterogeneity Within Type II Autosomal Dominant OsteopetrosisJournal of Bone and Mineral Research, 2000
- Prevalence of Low Femoral Bone Density in Older U.S. Adults from NHANES IIIJournal of Bone and Mineral Research, 1997
- Skeletal fluorosis: Histomorphometric analysis of bone changes and bone fluoride content in 29 patientsBone, 1989