The management of secondary osteoporosis

Ariella Kelman, Nancy E Lane

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Secondary osteoporosis is common among patients being evaluated for osteoporosis. All men and premenopausal women with unexplained bone loss or a history of a fragility fracture should undergo a work-up for secondary osteoporosis. Also, postmenopausal women with risk factors for secondary osteoporosis should be carefully evaluated. The evaluation should include a thorough history, physical examination, bone mineral density testing, and laboratory testing. While there is no consensus for a cost-effective laboratory evaluation, some recommendations include: 25-hydroxyvitamin D, parathyroid hormone (PTH), serum and urine calcium, phosphate, creatinine, liver function tests, a complete blood count, testosterone in men, and thyroid-stimulating hormone. After a thorough review of the evaluation for secondary osteoporosis, this chapter reviews the pathophysiology and treatment of secondary osteoporotic disorders, including vitamin D insufficiency, osteomalacia, the osteoporosis of erosive inflammatory arthritis, ankylosing spondylitis, systemic lupus erythematosus, and osteoporosis related to anti-androgenic therapy for prostate cancer and aromatase inhibitor therapy for breast cancer. Physicians have a significant responsibility to evaluate and treat the underlying medical problem that is the cause of secondary osteoporosis and to optimize bone health in the individual patient.

Original languageEnglish (US)
Pages (from-to)1021-1037
Number of pages17
JournalBest Practice and Research: Clinical Rheumatology
Issue number6
StatePublished - Dec 2005


  • Androgen deprivation therapy
  • Ankylosing spondylitis
  • Aromatase inhibitors
  • Glucocorticoids
  • Lupus
  • Osteomalacia
  • Osteonecrosis
  • Rheumatoid arthritis
  • Secondary osteoporosis
  • Vitamin D deficiency

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rheumatology


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