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Exclude secondary causes of osteoporosis

Authoring team

  • full blood count, ESR or C-reactive protein - for inflammatory causes of spinal deformities, marrow infiltration
  • serum and urine electrophoresis - in patients with vertebral fractures to exclude myeloma
  • biochemical profile, bone profile is usually normal unless the alkaline phosphatase is elevated due to recent fracture
  • TSH - to exclude hyperthyroidism
  • serum 25-hydroxy vitamin D and parathormone – in patients in certain at risk groups ie: asians, housebound, malabsorption, anticonvulsants, pelvic fracture or eating disorder
  • serum paraproteins and urine Bence Jones proteins
  • anti-endomysial antibody if coeliac disease suspected
  • Testosterone, Sex-hormone binding globulin, FSH, LH - to exclude treatable male hypogonadism
  • in pre-menopausal women especially if eating disorder or irregular menses: oestrogen, FSH, LH, prolactin
  • lateral thoracic and lumbar spine X-ray
  • isotope bone scan
  • bone biopsy

Reference:

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