Secondary osteoporosis and metabolic bone disease in patients 50 years and older with osteoporosis or with a recent clinical fracture: a clinical perspective.
OBJECTIVE
The purpose of this review is to provide guidance to clinicians about which laboratory tests should be performed in patients with osteoporosis or with a recent fracture.


RESULTS
Newly diagnosed secondary osteoporosis and other metabolic bone diseases (SECOB) have been found in 5-48% of patients with osteoporosis. In patients with a recent fracture, new SECOB is found in 10-47% of patients with osteoporosis, and in 26-51% if all patients with a fracture regardless of bone mineral density (BMD) are screened. More than one SECOB can be found in the same patient, even when they have already known SECOB. In primary hyperparathyroidism, hyperthyroidism, hypercortisolism, and multiple myeloma, both SECOB and its treatment have an impact on BMD and fractures. For other SECOBs, no treatment is available, or there are no data about the effect of treatment of the SECOB on BMD and fractures.


CONCLUSIONS
We recommend performing the following tests in all patients with osteoporosis or a recent clinical fracture: calcium, phosphate, creatinine, albumin, erythrocyte sedimentation rate in all patients, 24 h urine calcium in men and serum testosterone in men less than 70 years. On indication, additional tests can be performed.
aDepartment of Rheumatology, Atrium Medical Centre, Heerlen bDepartment of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht cDepartment of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands dUniversity of Hasselt, Hasselt, Belgium eDepartment of General Practice, Maastricht University, Maastricht, The Netherlands.
Sandrine P G
SP
Bours
Joop P W
JP
van den Bergh
Tineke A C M
TA
van Geel
Piet P M M
PP
Geusens
D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications*; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D012307:Risk Factors