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Secondary Osteoporosis: Differential Diagnosis and Workup

DIAB, DIMA L. MD*; WATTS, NELSON B. MD

Clinical Obstetrics and Gynecology: December 2013 - Volume 56 - Issue 4 - p 686–693
doi: 10.1097/GRF.0b013e3182a9b5f9
Osteoporosis: Diagnosis and Management

There are numerous causes of secondary osteoporosis including endocrine disorders, nutritional deficiencies, and other miscellaneous conditions and medications. It is essential to identify and address these factors to appropriately manage patients with osteoporosis. Failure to do so may result in further bone loss despite pharmacologic intervention for osteoporosis. The following diagnostic studies should be considered initially: complete blood count, complete metabolic panel, 25-hydroxyvitamin D level, testosterone level in men, and 24-hour urinary calcium, sodium, and creatinine. Further testing may be performed in selected patients depending on the clinical picture and results of the initial workup.

*Department of Internal Medicine, Division of Endocrinology/Metabolism, Cincinnati VA Medical Center, University of Cincinnati Bone Health and Osteoporosis Center;

Mercy Health Osteoporosis and Bone Health Services, Cincinnati, Ohio

The authors declare that they have nothing to disclose.

Correspondence: Dima L. Diab, MD, Department of Internal Medicine, Division of Endocrinology/Metabolism, Cincinnati VA Medical Center, Cincinnati, OH. E-mail: diabd@ucmail.uc.edu

© 2013 by Lippincott Williams & Wilkins.