How is secondary osteoporosis diagnosed?

Bone density testing: A bone densitometry (DEXA) test is the most accurate method for diagnosing osteoporosis. DEXA scanning uses low energy X-rays through a bone (spine, hip, or wrist) to determine bone mineral density, which can indicate the severity of osteoporosis and the probability of fractures.

What tests are done for osteoporosis?

To diagnose osteoporosis and assess your risk of fracture and determine your need for treatment, your doctor will most likely order a bone density scan. This exam is used to measure bone mineral density (BMD). It is most commonly performed using dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry.

What would be a secondary cause of osteoporosis?

There are numerous causes of secondary bone loss, including adverse effects of drug therapy, endocrine disorders, eating disorders, immobilization, marrow-related disorders, disorders of the gastrointestinal or biliary tract, renal disease, and cancer.

What is a DEXA scan for osteoporosis?

A bone density scan uses low dose X-rays to see how dense (or strong) your bones are. You may also hear it called a DEXA scan. Bone density scans are often used to diagnose or assess your risk of osteoporosis, a health condition that weakens bones and makes them more likely to break.

What medications can cause secondary osteoporosis?

The medications most commonly associated with osteoporosis include phenytoin, phenobarbital, carbamazepine, and primidone. These antiepileptic drugs (AEDs) are all potent inducers of CYP-450 isoenzymes.

What is the T score for severe osteoporosis?

A T-score between −1 and −2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis.

What is the most accurate test for osteoporosis?

The bone mineral density (BMD) test is the primary test used to identify osteoporosis and low bone mass. One of the preferred and most accurate ways to measure BMD is Dexa-Scan (dual-energy X-ray absorptiometry or DXA). It uses a low energy X-ray to evaluate bone density in the hip and/or spine.

What happens if osteoporosis is left untreated?

Osteoporosis left untreated increases the likelihood of fractures. Simple actions such as sneezing or coughing, making a sudden turn, or bumping into a hard surface can result in a fracture. This can make you feel like you’re walking on eggshells and cause you to refrain from participating in activities that you enjoy.

What medications cause secondary osteoporosis?

The medications most commonly associated with osteoporosis include phenytoin, phenobarbital, carbamazepine, and primidone.

Who is at risk for secondary osteoporosis?

Secondary osteoporosis can be present in pre- and post-menopausal women and in men. Up to 30% of post-menopausal women and 50 to 80% of men are found to have factors contributing to osteoporosis when undergoing an evaluation for underlying causes of the disease (2, 3).

What is a bad z score for osteoporosis?

“Osteopenia(bone mass lower than normal peak bone mass) is below minus one to minus 2.5. Lower than minus 2.5 is osteoporosis.” A negative Z score means you have thinner bones than the average of others in your age group; positive means you have better.

What are the two medications that may cause osteoporosis after long term use?

When to consider secondary osteoporosis in a fracture?

It may be suspected in patients who present with a fragility fracture despite having no risk factors for osteoporosis. In addition, secondary osteoporosis should be considered if the bone density Z-score is –2.5 or less. Consider the fracture site and presence of other clinical clues to guide investigations for an underlying cause.

Is there a test to diagnose secondary osteoporosis?

In an otherwise healthy patient with no specific clinical signs, a range of investigations may be required to identify a secondary cause of osteoporosis. The prevalence of undiagnosed secondary causes of osteoporosis is unknown and there are no guidelines regarding appropriate laboratory tests for the otherwise healthy patient.

Can a corticosteroid overdose cause secondary osteoporosis?

A careful drug history may identify possible causes. While corticosteroids are well known to cause osteoporosis and fragility fractures, a number of other drugs also increase fracture risk (see Box). However, not all patients with secondary osteoporosis will present with the classic signs of the underlying condition.

Is there evidence for osteoporosis screening in men?

The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis in men.