High bone mineral density

Last revised by Dr David Luong on 14 Feb 2022

A high bone mineral density is one where the bone mineral density (BMD) is usually greater than two standard deviations above what is expected for age. This can sometimes be seen on routine DEXA scan assessment. Some authors advocate a definition of a high BMD where the Z-score is greater than +2.5 to highlight to clinicians the potential for underlying pathology 2.

Pathology

A high bone mineral density may result from a number of varied mechanisms. It may be associated with conditions with increased fracture risk, or artifacts that themselves do not affect fracture risk but may mask low bone mineral density or in situations where fracture risk may be reduced but other comorbidities may occur.

Etiology
Focal
Generalized

Generalized acquired

Generalized inherited

Artifactual causes

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