Exclude secondary causes of osteoporosis
- 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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