Radiology of Osteopenia (Continued)
BMD determined by DXA is an areal measurement. The density in grams is divided by the area scanned to determine g/cm2. Meticulous detail is necessary to ensure follow-up scans measure…
MUSCULOSKELETAL MEDICINE
Progressive Spinal Deformity in Osteoporosis
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…
Involutional Osteoporosis
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…
Clinical Manifestations of Osteoporosis
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…
Vascular and Soft Tissue Calcification in Secondary Hyperparathyroidism of Chronic Renal Disease
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,…
Causes of Osteoporosis
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…
Clinical Guide to Vitamin D Measurement
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…
Hypophosphatasia
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…
Bony Manifestations of Renal Osteodystrophy
Radiographic examination of the skull may show irregular rarefaction of the calvaria (“salt-and-pepper” skull) and loss of the dense white line cast by the lamina dura surrounding the roots of…
Rickets, Osteomalacia, and Renal Osteodystrophy
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…
