Quantitative Ultrasonography (QUS) QUS, unlike diagnostic ultrasonography, uses a transmitting and receiving transducer. Frequencies are higher than used for diagnostic ultrasonography. The measurement reflects structure and mineral content by determining…
Radiography The identification of osteopenia on a radiograph requires a significant, 30% or greater, loss of bone mineral. There are two general types of bone loss, and the differentiation between…
WORKUP IN SYMPTOMATIC DISEASE Causes of symptomatic bone loss must be systematically excluded. The patient’s history may suggest bone loss secondary to hyperthyroidism, primary hyperparathyroidism, chronic glucocorticoid excess (hyperadrenalism or…
Multiple myeloma, the most common primary malignant bone tumor in adults, may be associated with profound generalized axial and appendicular osteopenia. Myeloma cells produce potent osteoclast-activating factors that stimulate bone…
Hyperadrenalism, or chronic glucocorticoid excess, whether endogenous (Cushing syndrome) or iatrogenic, leads to decreased bone mass. Glucocorticoid therapy results in a transient increase in bone resorption followed by a suppression…
In patients with HPP the predominant organs involved are the skeleton and teeth, which are hard tissues, even though there are high levels of TNSALP in many organs. Four of…
Osteoporosis is a heterogeneous disorder that is caused by multiple pathogenetic mechanisms. The clinical manifestation of osteoporosis is fracture, and the mechanisms that lead to fracture are multifactorial and include…
The circulating 25(OH)D concentration is the most reliable measure of overall vitamin D status, even though it is biologically inactive. 25(OH)D is measured by commercially available immunoassays, preferably by automated…
Treatment. Treatment of renal osteodystrophy is complex and the recent KDIGO guidelines are the best evidence-based guides for management. The first requirement is appropriate management of the chronic renal disease,…
The biochemical alterations in renal osteodystrophy can be summarized as follows: 1. Azotemia, hyperphosphatemia, and changes in acid-base balance and electrolytes that reflect the chronic acidotic state 2. Low serum…
