Lakhasly

Diagnosis The 2020 update of the American Association of Clinical Endocrinologists (AACE) guidelines provides the following criteria for the diagnosis of osteoporosis in postmenopausal women [11] : T-score −2.5 or below in the lumbar spine, femoral neck, total proximal femur, or 1/3 radius Low-trauma spine or hip fracture (regardless of BMD) T-score between −1.0 and −2.5 and a fragility fracture of proximal humerus, pelvis, or distal forearm T-score between −1.0 and −2.5 and high FRAX️ fracture probability based on country-specific thresholds The National Osteoporosis Guideline Group (NOGG) recommends considering the following as routine in the investigation of osteoporosis/fragility fractures [246] : Clinical history Physical examination including measurement of height and assessment of thoracic kyphosis Complete blood cell count Erythrocyte sedimentation rate or C-reactive protein Serum calcium, albumin, creatinine, phosphate, alkaline phosphatase, and liver transaminases Serum 25-hydroxyvitamin D Thyroid function tests The NOGG recommends that clinicians consider perform the following studies, as indicated [246] : Serum electrophoresis, immunoglobulins, and free light chain assay Plasma parathyroid hormone (PTH), if primary hyperparathyroidism suspected Serum testosterone, sex hormone–binding globulin, follicle-stimulating hormone, luteinizing hormone 24-h urinary free cortisol/overnight dexamethasone suppression test Serum prolactin Serum magnesium if hypocalcemic Tissue transglutaminase antibodies, ± endomysial antibodies (celiac disease screen) Urinary calcium excretion Markers of bone turnover (eg, carboxy–terminal collagen crosslinks [CTX], P1NP) Lateral radiographs of lumbar and thoracic spine or DXA-based lateral vertebral imaging Bone densitometry (DXA) if indicated by FRAX assessment and/or required for BMD monitoring Isotope bone scan

Diagnosis
The 2020 update of the American Association of Clinical Endocrinologists (AACE) guidelines provides the following criteria for the diagnosis of osteoporosis in postmenopausal women [11] :
T-score −2.5 or below in the lumbar spine, femoral neck, total proximal femur, or 1/3 radius
Low-trauma spine or hip fracture (regardless of BMD)
T-score between −1.0 and −2.5 and a fragility fracture of proximal humerus, pelvis, or distal forearm
T-score between −1.0 and −2.5 and high FRAX®️ fracture probability based on country-specific thresholds
The National Osteoporosis Guideline Group (NOGG) recommends considering the following as routine in the investigation of osteoporosis/fragility fractures [246] :
Clinical history
Physical examination including measurement of height and assessment of thoracic kyphosis
Complete blood cell count
Erythrocyte sedimentation rate or C-reactive protein
Serum calcium, albumin, creatinine, phosphate, alkaline phosphatase, and liver transaminases
Serum 25-hydroxyvitamin D
Thyroid function tests
The NOGG recommends that clinicians consider perform the following studies, as indicated [246] :
Serum electrophoresis, immunoglobulins, and free light chain assay
Plasma parathyroid hormone (PTH), if primary hyperparathyroidism suspected
Serum testosterone, sex hormone–binding globulin, follicle-stimulating hormone, luteinizing hormone
24-h urinary free cortisol/overnight dexamethasone suppression test
Serum prolactin
Serum magnesium if hypocalcemic
Tissue transglutaminase antibodies, ± endomysial antibodies (celiac disease screen)
Urinary calcium excretion
Markers of bone turnover (eg, carboxy–terminal collagen crosslinks [CTX], P1NP)
Lateral radiographs of lumbar and thoracic spine or DXA-based lateral vertebral imaging
Bone densitometry (DXA) if indicated by FRAX assessment and/or required for BMD monitoring
Isotope bone scan