EVALUATION OF SECONDARY OSTEOPOROSIS WITH BONE MINERAL DENSITOMETRY AND BONE TURNOVER MARKERS

Abstract

Osteoporosis is as a very complex multi-factorial pathogenesis; thereby any doctor facing a case of osteoporosis must be very careful. Diagnostic procedures are complex and include careful monitoring of the history of patient, physical examination and some laboratory analysis. In this study, 201 patients aged between 50 and 95 years were selected from 4872 patients consulting orthopedic clinics. This group (201 patients: 168 women, 33 men) showed evidence of osteoporosis: BMD DXA with reduced bone mineral density,T-score: greater than -2.5 SD, or X-ray signs of non traumatic fractures. Patients also underwent biochemical and instrumental investigations for an assessment of bone metabolism. Age, gender, medical history as well as tests of rheumatic metabolism, calcium-phosphorus and some indices of bone turnover were determined for each patient. Interestingly, our data showed that 104 patients had a vertebral fracture without trauma, 22 hypothyroid patients were undergoing treatment with levothyroxine, 3 patients were suffering from autoimmune thyroiditis, 3 patients were suffering from secondary hyperparathyroidism with vitamin D deficiency, 2 patients were suffering from adenoma with primary hyperparathyroidism, 20 were diabetic patients, 7 patients had monoclonal gammopathy, 7 women had hystero- ovario salpingectomy, 7 patients were HCV positive, 4 patients with rheumatoid arthritis had been treated with corticosteroids, 2 patients were suffering from multiple myeloma, and 1 patient had Crohn's disease. There was also 1 suspected case of ulcerative colitis, 5 patients were suffering from celiac disease and other cases described in the paper. As a result of this diverse association, the approach to treating osteoporotic patients should be then accurate and multidisciplinary. It is then important to perform laboratory tests and investigations for correct diagnosis and adequate treatment.