Which T-score should be chosen to make a diagnosis?

• A. The highest T-score
• B. The lowest T-score
• C. The average T-score
• D. Any T-score

Answer: (B)

In the context of diagnosing osteoporosis using bone densitometry, the T-score is a critical numerical value representing how a patient's bone density compares to that of a healthy young adult. A lower T-score indicates a greater divergence from the norm, which is associated with a higher risk of fractures and osteoporosis.

Selecting the lowest T-score for diagnosis is essential because this value provides the most accurate reflection of the patient's bone health status. It highlights the area of greatest concern in terms of bone density, identifying the weakest point in the bone structure that may predispose the patient to fractures. When diagnosing osteoporosis, a T-score of -2.5 or lower is indicative of the condition, making the lowest T-score the most relevant metric for determining the patient’s risk.

Choosing the highest, average, or any T-score may mask the areas of significant concern regarding bone density, leading to an inaccurate or delayed diagnosis. Focusing on the lowest T-score ensures clinicians can implement appropriate interventions, monitor the patient's progression, and manage treatment effectively.