This patient has a lumbar spine (L1-L4) bone mineral density (BMD) of 0.410 g/cm2 (cross on the reference database graph) measured by dual-energy x-ray absorptiometry and a T-score of −5.79. The reference database graph displays age- and sex-matched mean BMD levels ±2 SDs (shaded areas) derived from a normative database from the manufacturer, Hologic Inc, Bedford, Massachusetts. T-score indicates the difference in SD between the subject's BMD and the predicted sex-matched mean peak young adult BMD; Z-score, the difference in SD between the subject's BMD and the sex- and age-matched BMD level; and percentage of mean, the subject's BMD as a percentage of the mean peak young adult BMD- or age-matched BMD level. (Adapted from bone densitometry report, QDR-4500C bone densitometer; Hologic Inc, Bedford, Massachusetts.) Source: Chapter 23. Geriatric Endocrinology, Greenspan’s Basic & Clinical Endocrinology, 9e Citation: Gardner DG, Shoback D. Greenspan’s Basic & Clinical Endocrinology, 9e; 2011 Available at: https://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/Books/gard9/gard9_c023f014.jpg&sec=39750842&BookID=380&ChapterSecID=39744063&imagename= Accessed: October 21, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved