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Joint Bone Spine
Volume 85, n° 6
pages 693-699 (décembre 2018)
Doi : 10.1016/j.jbspin.2018.01.007
accepted : 29 November 2017

High bone mass in adults

Julien Paccou a, b, , Laetitia Michou c, Sami Kolta d, Françoise Debiais e, Bernard Cortet a, b, Pascal Guggenbuhl f, g, h
a Département de rhumatologie, université de Lille, 59000 Lille, France 
b PMOI, EA 4490, 59000 Lille, France 
c Division de rhumatologie, département de médecine, CHU de Québec, université Laval, Québec, G1V4G2 QC, Canada 
d Inserm, U 1153, département de rhumatologie, hôpital Cochin, Université Paris Descartes, 75014 Paris, France 
e Service de rhumatologie, CHU de Poitiers, 2, rue de La-Milétrie, BP 577, 86021 Poitiers cedex, France 
f Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France 
g Inserm UMR 991, 35043 Rennes, France 
h Université Rennes 1, faculté de médecine, 35043 Rennes, France 

Corresponding author. Département de rhumatologie, université de Lille, rue Emile-Laine, 59037 Lille, France.Département de rhumatologie, université de Lille, rue Emile-Laine, 59037 Lille, France.

A finding of high bone mineral density (BMD) from routine dual-energy X-ray absorptiometry (DXA) screening is not uncommon. No consensus exists about the definition of high BMD, and T-score and/or Z-score cutoffs of ≥+2.5 or ≥+4 have been suggested. The many disorders that can result in high BMD are usually classified based on whether the BMD changes are focal vs. generalized or acquired vs. constitutional. In over half the cases, careful interpretation of the DXA report and images identifies the cause as an artefact (e.g., degenerative spinal disease, vascular calcifications, or syndesmophytes) or focal lesion (e.g., sclerotic bone metastasis or Paget's disease). Generalized acquired high BMD may be secondary to a diverse range of disorders such as fluorosis, diffuse bone sclerosis related to renal osteodystrophy, hematological diseases, and hepatitis C. Identification of the cause may require additional investigations such as imaging studies, serum tryptase assay, or serological tests for the hepatitis C virus. Finally, high BMD is a feature of many genetic diseases, most notably osteopetrosis and the disorders caused by mutations in the sclerostin gene SOST (sclerosing bone dysplasia and van Buchem disease) or in the LRP5 gene encoding the low-density lipoprotein receptor-related protein 5 (which is the Wnt co-receptor)

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Keywords : Bone mineral density, High bone mineral density, High bone mass, Bone sclerosis, Osteopetrosis, Sclerostin, LRP5

© 2018  Société française de rhumatologie@@#104156@@