Metabolic Bone Disease
1. The major risk factors for fragility fractures are low bone mass, advancing age, previous fragility fractures, corticosteroid use, and the propensity to fall.
2. Disorders causing secondary bone loss are present in approximately one-third of women and two-thirds of men who have osteoporosis.
3. Patients with osteoporosis should have a complete history and physical examination and key, cost-effective laboratory tests to identify any underlying responsible disorders.
4. High doses and prolonged use of glucocorticoids (GCs) produce greater risk, but all doses of oral GCs and even inhaled steroids increase the risk of osteoporotic fractures.
5. GC-induced osteoporosis (GIOP) results from a combination of suppressed bone formation and enhanced bone resorption accounting for the rapid bone loss often seen in GC-treated patients.