Which term describes osteoporosis with a history of fracture?

• A. Osteopenia
• B. Osteoporosis
• C. Severe osteoporosis
• D. Normal bone density

Answer: (C)

When osteoporosis includes a fragility fracture, clinicians describe it as severe osteoporosis. A fragility fracture is a fracture that results from a low-energy event, such as a fall from standing height, indicating that bone strength is significantly compromised beyond what is captured by bone density alone. This combination—bone loss plus a prior fracture—signals a more advanced and higher-risk state, hence the term severe osteoporosis.

Osteopenia refers to bone density that is below normal but not yet in the osteoporosis range, so it doesn’t account for a fracture history. Osteoporosis describes low bone density (T-score ≤ -2.5) regardless of fracture history, but when a fracture has already occurred, the more precise label is severe osteoporosis. Normal bone density would not describe osteoporosis at all.