Sunday, 1 December 2013

Osteoporosis - Diagnostic tests, biochemical markers

Diagnostic tests:
Patients with osteoporosis should be screened for other conditions that lead to osteoporosis.
Serum PTH, calcium, phosphorus & alkaline phosphatase for primary hyper parathyroidism.
 Renal function tests: for secondary hyperparathyroidism with chronic renal failure.
Blood count & smear, sedimentation rate, protein electrophoresis for multiple myeloma, leukemia or lyphoma. Thyroid function tests: for hyperthyroidism & excessive thyroid hormone treatment. Careful history & laboratory studies to rule out hyper cortisolism, alcohol abuse & metastatic cancer. Serum calcium, phosphorus, alkaline phosphatase & 125 dihydrosy vit D levels are all normal in  patients with osteoporosis.

Biochemical markers of bone turnover:
Markers of bone formation include serum levels of osteocalcin, total bone & alkaline phosphatase & procollagen peptide.
Bone resorption is indicated by changes in urinary calcium, hydroxyproline,pyridinoline, the collagen cross linked N telopeptides or C telopeptides.

Changes of bone remodeling
Pathophysiology
Signs and symptoms
Risk factors and investigations
Investigations
Diagnostic tests and biochemical markers
Hormonal treatment
Estrogen modulators, calcium
Vitamin D
Bisphosphonates
Calcitonin, Fluoride, Tibolone
Prevention

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