Table 2.

Procedures in the investigation of osteoporosis

Routine:

○ History and physical examination

○ Blood cell count, sedimentation rate or C-reactive protein, Serum Calcium, Albumin, Creatinine, phosphate, alkaline phosphatase, Liver transaminases

○ Thyroid function tests

○ Bone densitometry (DXA)

○ 25 OH Vitamin D

• If suspicion for secondary osteoporosis following tests are included in initial work up:

■ Lateral radiographs of lumbar and thoracic spine/DXA-based vertebral imaging

■ Protein immunoelectrophoresis and urinary Bence-Jones proteins (Myeloma)

■ Serum prolactin

■ 24 hour urinary cortisol/dexamethasone suppression test (Cushing's)

■ Endomysial and/or tissue transglutaminase antibodies (Celiac disease)

■ Isotope bone scan

■ Markers of bone turnover.

■ Urinary calcium excretion, Intact parathyroid hormone (Hyperparathyroidism)