Sublesional Osteoporosis (SLOP) Detection and Diagnosis

To assess and understand your patient’s bone health, it is important to measure their BMD and document their fracture risk. We advocate diagnosing the presence of SLOP based on the following DXA criteria:

Table 4. Definition of SLOP

Age Range Definition
Men ≥ 60 years or postmenopausal women Hip or knee region T-score ≤ -2.5
Men < 59 years or premenopausal women Hip or knee region Z-score < -2.0 with ≥ 3 risk factors for fracture
Men or women age 16–90 Prior fragility fracture and no identifiable etiology of osteoporosis other than SCI
The T-score is the number of standard deviations (SD) BMD is above or below sex-specific young adult mean peak bone mass. The Z-score is the number of SD BMD is above or below that expected for individuals of the same age and sex.
Reprinted from Topics in Spinal Cord Injury Rehabilitation, Vol. 14, Craven BC, Robertson LA, McGillivray CF, Adachi JD, Detection and treatment of sublesional osteoporosis among patients with chronic SCI: Proposed paradigms, pp. 1–22, © 2009. Reproduced with permission from Thomas Land Publishers, Inc.