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OsteoporosisCauses
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Age and female are biggest risk factors Prevalence 2% at 50 years, 25% at 80 years in women ''Important other risk factors'' (used by FRAX) history of glucocorticoid use rheumatoid arthritis alcohol excess history of parental hip fracture low body mass index current smoking ''Other risk factors'' sedentary lifestyle premature menopause Caucasians and Asians endocrine disorders: hyperthyroidism, hypogonadism (e.g. Turner's, testosterone deficiency), growth hormone deficiency, hyperparathyroidism, diabetes mellitus multiple myeloma, lymphoma gastrointestinal disorders: inflammatory bowel disease, malabsorption (e.g. Coeliac's), gastrectomy, liver disease chronic kidney disease osteogenesis imperfecta, homocystinuria ''Medications'' may worsen osteoporosis (other than glucocorticoids) long term heparin therapy proton pump inhibitors glitazones aromatase inhibitors e.g. anastrozole ''Investigations for secondary causes'' ? do ... exclude diseases that mimic osteoporosis (e.g. osteomalacia, myeloma); identify cause and contributory factors; assess risk of subsequent fractures; select most appropriate form of treatment Do for all ... History and physical examination FBC, ESR/CRP, U/E, Cr, Ca, PO4, Alb, LFT, TFT DEXA ''? Other procedures'' Xrays lumbar and thoracic spine/DXA-based vertebral imaging Protein immunoelectrophoresis and urinary Bence-Jones proteins 25OHD PTH Serum testosterone, SHBG, FSH, LH (in men), Serum prolactin 24 hour urinary cortisol/dexamethasone suppression test Endomysial and/or tissue transglutaminase antibodies (coeliac disease) Isotope bone scan Markers of bone turnover, when available Urinary calcium excretion
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Osteoporosis