How should DEXA results be interpreted in terms of T-scores and initial management thresholds?

• A. T-score ≤ -2.5 osteoporosis; -1 to -2.5 osteopenia; manage with calcium/vitamin D, exercise, and consider pharmacotherapy for osteoporosis
• B. T-score ≥ 1.0 indicates osteoporosis
• C. Osteopenia is T-score ≤ -2.5
• D. DEXA results do not guide therapy

Answer: (A)

DEXA interpretation relies on T-scores that compare a patient’s bone density to that of a young, healthy reference population. A T-score of -2.5 or lower defines osteoporosis, a T-score between -1.0 and -2.5 defines osteopenia, and a T-score above -1 is considered normal. For initial management, osteoporosis is treated with calcium and vitamin D, exercise, and fall-prevention measures, with pharmacotherapy added when osteoporosis is present. Osteopenia warrants lifestyle measures and supplementation, with treatment decisions guided by overall fracture risk. So this approach matches how T-scores categorize bone density and how those categories inform early management.