Fig. 1.

Representative DXA studies of a the proximal femur and b the lumbar spine of a 68-year-old woman. The lowest T-score of total and femoral neck regions of interest is used to grade the bone as normal, osteopenic, or osteoporotic. a In this postmenopausal woman, the T-score of the proximal femur was −2.1 which is in the osteopenic range according to the WHO osteoporosis definition. b L1–4 DXA image of the lumbar spine in the same postmenopausal women (68 years). The total T-score of the lumbar spine involving L1 to L4 is −3.0 and therefore in the osteoporotic range. Please note the discordance between the two T-scores as they fall into different, but adjacent classes (osteopenic versus osteoporotic). Priority is given in this case to the osteoporotic T-score and the patient should be diagnosed as osteoporotic