Secondary osteoporosis and metabolic bone disease in patients 50 years and older with osteoporosis or with a recent clinical fracture: a clinical perspective

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Abstract

Purpose of review

The purpose of this review is to provide guidance to clinicians about which laboratory tests should be performed in patients with osteoporosis or with a recent fracture.

Recent findings

Newly diagnosed secondary osteoporosis and other metabolic bone diseases (SECOB) have been found in 5-48% of patients with osteoporosis. In patients with a recent fracture, new SECOB is found in 10-47% of patients with osteoporosis, and in 26-51% if all patients with a fracture regardless of bone mineral density (BMD) are screened. More than one SECOB can be found in the same patient, even when they have already known SECOB. In primary hyperparathyroidism, hyperthyroidism, hypercortisolism, and multiple myeloma, both SECOB and its treatment have an impact on BMD and fractures. For other SECOBs, no treatment is available, or there are no data about the effect of treatment of the SECOB on BMD and fractures.

Summary

We recommend performing the following tests in all patients with osteoporosis or a recent clinical fracture: calcium, phosphate, creatinine, albumin, erythrocyte sedimentation rate in all patients, 24 h urine calcium in men and serum testosterone in men less than 70 years. On indication, additional tests can be performed.

Original languageEnglish
Pages (from-to)430-439
Number of pages10
JournalCurrent Opinion in Rheumatology
Volume26
Issue number4
DOIs
Publication statusPublished - Jul 2014

Keywords

  • etiology of osteoporosis
  • fractures
  • metabolic bone disease
  • secondary osteoporosis
  • ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM
  • 3RD INTERNATIONAL WORKSHOP
  • FAMILIAL HYPOCALCIURIC HYPERCALCEMIA
  • SUBCLINICAL THYROID-DYSFUNCTION
  • MINERAL DENSITY
  • POSTMENOPAUSAL WOMEN
  • RISK-FACTORS
  • UNDETERMINED SIGNIFICANCE
  • MONOCLONAL GAMMOPATHY
  • RHEUMATOID-ARTHRITIS

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