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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