Endocrinology

Many patients are interested in romosozumab for "maximizing bone gain" and preventing future fractures. Some have had anabolic therapy with teriparati...

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Which fracture sites outside of the classical spine and hip are considered to be osteoporotic fractures even in the absence of a bone density diagnosis?

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What is the utility of an oral calcium loading test to differentiate FHH from secondary hyperparathyroidism due to low calcium intake?

The patient has very low urinary calcium despite calcium supplements, vitamin D used to be low now normal. Continues to have elevated PTH with normal ...

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What range of musculoskeletal complaints have you seen with romosozumab use?

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Would you consider exploratory surgery in a young patient with normocalcemic hyperparathyroidism that meets one or more criteria for parathyroidectomy but has no localized pathology on advanced neck imaging?

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What is your approach to managing osteoporosis in patients with end stage kidney disease?

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How do you reduce the risk of contralateral fracture in a patient with atypical femur fracture from prolonged bisphosphonate use?

Do anabolic agents have a role?

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Would you use romosozumab in a patient with a cardiovascular event more than 2 years prior?

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Would you refer a patient for parathyroidectomy if they have normal calcium levels, mild hyperparathyroidism, and evidence of osteopenia?

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Do you recommend osteoporosis medication in postmenopausal females on anastrozole with very low Vitamin D (4.5)?

After replacing Vitamin D, what will be your first treatment of choice? Labs including ALP and calcium levels are normal. T scores are -3 or above. Th...

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Following abaloparatide use for osteoporosis treatment, how long do you consolidate with bisphosphonates before considering a drug holiday?

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After completing 12 months romosozumab, what is the next best treatment option for patients with severe osteoporosis, high risk for fracture, and normal kidney function?

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Should patients who develop primary hyperparathyroidism after 5 years of Prolia treatment for osteoporosis be referred for parathyroidectomy?

If so, when? Does surgery need to be timed with last dose of Prolia injection?

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How should patients time the ingestion of their alendronate and levothyroxine given issues with food/drug interactions?

With the time intervals recommended after taking each medicine, I am wondering how patients should be counseled.

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How do you distinguish between primary and tertiary hyperparathyroidism in a patient with ESRD?

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Would you consider anabolic osteoporosis therapy in a young adult male with multiple non-traumatic vertebral compression fractures and low bone density for age (Z-score -2.6)?

A male patient in his 30s with two lumbar compression fractures (non-traumatic) and a Z-score of -2.6 in the spine, Z-score -0.5 in hips. History of 3...

1 Answer available

How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?

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Do you treat hypercalciuria in post menopausal osteoporosis with normal serum calcium and PTH?

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Aside from lifestyle measures such as calcium intake, vitamin D repletion, and weight-bearing exercises and ruling out all secondary causes, what is the preferred approach to managing osteoporosis in young women with Z score of less than -2.5 and planning to get pregnant soon?

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In patients with secondary osteoporosis due to primary hyperparathyroidism, should parathyroidectomy be recommended in the setting of recent prior bisphosphonate use?

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Have the results of the ancillary study of the VITAL trial, demonstrating that Vitamin D3 supplementation did not reduce the incident rate of fractures in generally healthy midlife and older adults, changed how you prescribe Vitamin D?

PMID 35939577

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How do you manage osteoporosis in patients with anorexia nervosa (who often are young women < 40)?

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Is it possible for certain individuals with osteoporosis to be a denosumab "non-responder"?

I’ve seen several such patients who have no secondary causes for bone loss, on adequate calcium/vitamin D, and compliant with denosumab who do n...

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Can joint replacement surgery be performed in someone with active Paget’s disease elsewhere?

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Despite low T scores (-2.5 or worse), what is the actual fracture risk in relatively younger patients (early 50s to mid 60s) with low BMD?

Should this patient population be treated differently? At our institution, we have started using EPIC to screen many patients for osteoporosis and ou...

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Would you start osteoporosis treatment in patients with low FRAX scores but have T scores lower than -2.5?

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How should very low T scores (worse than -3) be interpreted in very thin patients (BMI < 18)?

1 Answer available