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Differential Diagnosis of Metabolic Bone Diseases

- See: Transient Osteoporosis:

  Disorder      Serum Ca    Serum Phos    Serum AP    Urine
Osteoporosis    Normal      Normal        Normal      Normal Ca
Osteomalacia      "           "              "        Low    Ca
HyperParaThy    Hi- Norm    Low -Norm         "       High   Ca
HypoParaThy     Low         High
Renal OsteoD    Low         High          High        - - - -
Paget's dz      Normal      Normal        High        Hydroxyproline
Myeloma           "           "             "         Protein
Rickets
   Vit-D def    Normal      Low
   Vit-D dep    Low        
Low
   Vit-D res    Normal      Very Low



                  Osteomalacia         Osteoporosis        HyperPara       Renal
           Vit D def  HypoPhos   Idiopathic  2ndary
Serum Ca    Low   Normal         Normal      Normal          High          Norm/Low
Serum P     Low   Very Low   Normal      Normal   Low         High
Alk Phos    High     High      Normal      Normal      Norm/High    High
Urine Ca    Low         Normal     Normal    Norm/High  Norm/High   Very low
Osteocalcin Norm/Incr   High       Normal      High     High        High
HydroxyPro  Norm/Incr   High       Normal      High     High        High
X-rays      Decr Density and         Decr Density       Norm/Osteitis Fibrosa
              Looser's Zones
Biopsy      Incr Osteoid Volume    Thin Cortx & Trabec  Norm/Osteitis Fibrosa
                                     and bone loss



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