Osteoporosis Redux

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FIGURE 1.
Images from March 2002 (A) and June 2006 (B), with the latter revealing an incidental superior end-plate fracture of L3 diagnosed on this DXA-based vertebral fracture analysis. Although the images are not intended for other diagnostic purposes, intervertebral disk disease is evident on both images.

TABLE 1

Reported Fracture Efficacy of Drugs Used or Proposed for Use in Treating Osteoporosis in Postmenopausal Women Irrespective of Diagnostic Method

SERM = selective estrogen-receptor modulator.
It should be recognized that not all trials are powered to reveal the full spectrum of fracture efficacy and that these data have also been subject to critical review questioning some interpretations (92). Also, not all these data apply to all patients.

TABLE 2

Some Secondary Causes of Bone Loss

Category	Cause
Medications	Oral or parenteral glucocorticoids for more than 3 mo
	Excessive doses of thyroxine
	Aromatase inhibitors
	Phenytoin
	Heparin
	Cytotoxic and immunosuppressive agents
	Intramuscular methoxyprogesterone
Genetic disorders	Osteogenesis imperfecta
	Thalassemia
	Hypophosphatasia
	Hemochromatosis
	Disordered calcium balance
	Hypercalciuria
	Vitamin D deficiency
	Endocrine disease
	Cushing syndrome and disease
	Gonadal insufficiency
	Hyperthyroidism
	Type 1 diabetes mellitus
	Primary hyperparathyroidism
	Gastrointestinal disease
	Malabsorption syndromes
	Chronic liver disease
	Prior gastrectomy or gastroenterostomy
Other disorders	Myeloma, lymphoma, and leukemia
	Systemic mastocytosis
	Nutritional disorders (e.g., anorexia nervosa)
	Rheumatoid disease
	Chronic renal disease