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Review
. 2022 Feb;20(1):1-12.
doi: 10.1007/s11914-022-00717-y. Epub 2022 Jan 15.

Evaluating Patients for Secondary Causes of Osteoporosis

E Michael Lewiecki  1
Affiliations
Review

Evaluating Patients for Secondary Causes of Osteoporosis

E Michael Lewiecki. Curr Osteoporos Rep. 2022 Feb.

Abstract

Purpose of review: This review provides suggestions for the evaluation of patients with osteoporosis in order to assure that the diagnosis is correct, to identify potentially correctable conditions contributing to skeletal fragility and fracture risk, and to assist in individualizing management decisions.

Recent findings: Some patients who appear to have osteoporosis have another skeletal disease, such as osteomalacia, that requires further evaluation and treatment that is different than for osteoporosis. Many patients with osteoporosis have contributing factors (e.g., vitamin D deficiency, high fall risk) that should be addressed before and after starting treatment to assure that treatment is effective and safe. Evaluation includes a focused medical history, skeletal-related physical examination, assessment of falls risk, appropriate laboratory tests, and rarely transiliac double-tetracycline labeled bone biopsy. Evaluation of patients with osteoporosis before starting treatment is essential for optimizing clinical outcomes.

Keywords: Laboratory; Osteomalacia; Osteoporosis; Risk; Testing.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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