Disuse osteopenia

Disuse osteopenia is the localized loss of bone secondary to the lack of normal mechanical stresses on the bone. This is usually due to decreased use or even complete immobilization of a limb. Common causes include fractures, neuromuscular diseases, frailty, arthritis and voluntary inactivity/sedentary lifestyle.

Pathology

The loss of bone mass has to be substantial before it is subjectively visible on plain radiographs, usually 30-50% .

Radiographic features

The main radiographic feature is the loss of bone density in a regional/localized distribution (cf. generalized osteopenia/osteoporosis). On plain radiographs, this is usually a subjective assessment. On DEXA or CT quantitative, measurements can be performed . DEXA tends to be preferred, primarily due to its availability and much lower radiation dose.

Differential diagnosis

Any cause of regional osteopenia:

• complex regional pain syndrome
• osteomyelitis
• transient osteoporosis of the hip
• regional migratory osteoporosis
• erosive arthritis, e.g. rheumatoid arthritis
• lytic phase of Paget disease
• early bone infarct
• healing fractures
• hypervascular neoplasms

Siehe auch:

• Morbus Sudeck
• Osteoporose
• diffuse periarticular osteopenia
• Atrophie nach Entlastung

und weiter:

• diffuse periartikuläre Demineralisation