Osteoporosis or Osteopenia?

Patient: I have a question about DEXA scan results and two different diagnoses. I’m only a 46 year old male and have had a few compression fractures over the past few years. Both were while putting strain on my back from lifting. The Doctor had me get a DEXA scan and the results were a Z score of 3.11 standard deviations below the peak bone mass of an age matched cohort in my lumbar spine, and 2.29 below for my left hip. The results said a “Z” score was used instead of a T-Score because I am under 50. The question is whether the 3.11 is considered osteoporosis, or osteopenia I was told the -2.29 in the hip is osteopenia, but it is unclear about the 3.11 in the spine. The reason the term matters is it makes a difference in what help I can get since I lost my health insurance.

Doctor: Dual-energy X-ray absorptiometry (DXA) is currently the referred technique for assessing bone mineral density. Bone Min neral Density results are reported as T-scores and Z-scores. T-scores are the number of standard deviations below the mean BMD A T-score of 0 means that the patient has a BMD value equal to the mean for young adults. A T-score of -2.5 means that the patient has a BMD value that is 2.5 standard deviations below the mean. A Z-score is the number of standard deviations below or above the mean BMD value .World Health Organization Criteria for Osteoporosis:Normal: T -score > -1.0 (below the young adult reference range)Low Bone Mass (Osteopenia): T-score -1.0 to -2.5Osteoporosis T-Score < -2.5