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Osteoporosis - Secondary (Type II)

This is an 3D medical animation video to show what is osteoporosis and how it cause weakness to bone and the effect of osteoblast and osteoclast cells in it.also it shows the later stage and diagnosis of osteoporosis

What are the other Names for this Condition? (Also known as/Synonyms)

  • Secondary Osteoporosis
  • Type II Osteoporosis

What is Secondary Osteoporosis? (Definition/Background Information)

  • Secondary Osteoporosis is a condition that results from other medical conditions. A large number of conditions can cause skeletal damage as a secondary symptom. When this occurs, the individual is diagnosed with Secondary Osteoporosis
  • Unlike primary osteoporosis, which results from hormone imbalances after menopause, the root cause of Secondary Osteoporosis is another medical condition. These medical conditions interfere with creating bone mass and may cause bone loss, resulting in Osteoporosis.
  • The signs and symptoms of Secondary Osteoporosis are similar to primary osteoporosis. In most cases, it does not become apparent until an injury has occurred that results in bone damage
  • It is more difficult to treat Secondary Osteoporosis compared to Primary Osteoporosis. This is due to the fact that treatment often has to include treating the underlying cause of the disease along with treating osteoporosis

Who gets Secondary Osteoporosis? (Age and Sex Distribution)

  • Men and women of all ages are susceptible to developing Secondary Osteoporosis.
  • Individuals who have another medical condition that causes bone loss or damage are at the highest risk of developing Secondary Osteoporosis. Furthermore, individuals with hormonal imbalances can also develop it
  • Women are at a higher risk due to the fact that they have lower peak bone masses and have weaker bones compared to men. 

What are the Risk Factors for Secondary Osteoporosis? (Predisposing Factors)

Common risk factors of Secondary Osteoporosis include:

  • Medical condition that can cause bone loss
  • Genetics/family history
  • Gender - women are at a higher risk
  • Hormonal imbalances
  • Low calcium diet

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. 

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Secondary Osteoporosis? (Etiology)

  • Secondary Osteoporosis is caused by another medical condition that results in bone loss or bone weakening as a secondary symptom.
  • Common medical conditions that result in Secondary Osteoporosis can include:
    • Kidney failure
    • Cushing’s disease (tumor in the pituitary gland that results in hormone imbalances)
    • Liver impairment
    • Anorexia
    • Bulimia
    • Arthritis
    • Multiple myeloma (tumors in the bone and bone marrow)
    • Leukemia (unrestrained white blood cell growth that increases your susceptibility to infection)
  • Secondary Osteoporosis can also be caused by hormonal conditions, including:
    • Hyperparathyroidism (increased parathyroid hormone production which increases the rate of bone resorption)
    • Hyperthyroidism (increased secretion by the thyroid glands)
    • Diabetes (body does not correctly produce insulin, which results in increased blood sugar and an increased susceptibility to infection) 
  • The similarity between all of these medical conditions is the fact that they cause bone weakening. While the mechanism may vary between diseases, calcium resorption is usually increased and results in rapid bone loss and weakening.

What are the Signs and Symptoms of Secondary Osteoporosis?

Common signs and symptoms of Secondary Osteoporosis include:

  • Signs and symptoms related to the presence of another medical condition
  • Hormonal imbalances
  • Weak joints
  • Injury after minor trauma
  • Fractures caused by minor trauma
  • Broken bones

In most cases, Secondary Osteoporosis does not become apparent until an injury has already occurred. Most people do not realize that they have osteoporosis until they fracture or break a bone.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

How is Secondary Osteoporosis Diagnosed?

  • Secondary Osteoporosis is often difficult to diagnose because it does not become apparent until an injury has already occurred.
  • Individuals who suffer from a medical condition that commonly causes Secondary Osteoporosis are encouraged to get a bone density test. This can be done through:
    • Ultrasounds or X-rays to image the skeletal system
    • Bone densitometry test to determine bone density by detecting photon absorption by bones
  • In many cases, a blood test may also be required to measure hormone levels, calcium levels, and vitamin D levels in the blood.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Secondary Osteoporosis?

  • The most common complication that arises from Secondary Osteoporosis is the possibility of a fracture or broken bones due to weakened bones or bone loss.
  • Other complications may arise due to the primary medical condition that is causing Secondary Osteoporosis. These vary depending on the condition.

How is Secondary Osteoporosis Treated?

  • Many medications are available to treat Secondary Osteoporosis.
    • Antiresorptive drugs (bisphosphonates, calcitonin, selective estrogen-receptor modulators) - slow down bone breakdown by blocking calcium resorption
    • Anabolic drugs - bone-forming drugs that restore bones and prevent breakages
  • Medical professionals also recommend changing your diet to include more vitamin D and calcium. Both help maintain bones and optimize bone formation. If this does not help, vitamin D and calcium supplements may be prescribed.
  • While treating the osteoporosis is important, it is also vital to receive treatment for the primary medical condition that is causing it. These vary depending on the disease.

How can Secondary Osteoporosis be Prevented?

  • Because Secondary Osteoporosis is caused by another medical condition, it is difficult to prevent the disease.
  • It is important to take precautions by maintaining a healthy diet and lifestyle and exercising regularly. This will help keep bones strong and keep your body functioning at a high level. 

What is the Prognosis of Secondary Osteoporosis? (Outcomes/Resolutions)

  • While it is difficult to undo the damage that is caused by Secondary Osteoporosis, with proper use of medications, individuals can mend their bones and overcome any injuries that they suffer.
  • Life expectancy greatly varies in individuals with Secondary Osteoporosis because the cause is different amongst them. To improve your outcome, it is important to combine treatment of Secondary Osteoporosis with treatment of the primary medical condition.

Additional and Relevant Useful Information for Secondary Osteoporosis:

The following DoveMed website link is a useful resource for additional information:


What are some Useful Resources for Additional Information?

NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
2 AMS Circle Bethesda, MD 20892-3676
Phone: (202) 223-0344
Toll-Free: 1 (800) 624-BONE (2663)
TTY: (202) 466-4315
Fax: (202) 293-2356
Email: NIHBoneInfo@mail.nih.gov
Website: http://www.bones.nih.gov

International Osteoporosis Foundation (IOF)
9, rue Juste-Olivier, CH-1260 Nyon, Switzerland
Phone: +41 22 994 0100
Fax: +41 22 994 0101
Email: info@iofbonehealth.org
Website: http://www.iofbonehealth.org

References and Information Sources used for the Article:

http://www.iofbonehealth.org/secondary-osteoporosis (accessed on September 2, 2013)

http://spinerevolution.com/osteoporosis/ (accessed on September 2, 2013)

http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/secondary-osteoporosis.aspx (accessed on September 2, 2013)

http://www.osteoporosis.ca/osteoporosis-and-you/secondary-osteoporosis/ (accessed on September 2, 2013)

Helpful Peer-Reviewed Medical Articles:

Bours, S. P., van Geel, T. A., Geusens, P. P., Janssen, M. J., Janzing, H. M., Hoffland, G. A., ... & van den Bergh, J. P. (2011). Contributors to secondary osteoporosis and metabolic bone diseases in patients presenting with a clinical fracture. The Journal of Clinical Endocrinology & Metabolism, 96(5), 1360-1367.

Ulivieri, F. M., Silva, B. C., Sardanelli, F., Hans, D., Bilezikian, J. P., & Caudarella, R. (2014). Utility of the trabecular bone score (TBS) in secondary osteoporosis. Endocrine, 47(2), 435-448.

Mirza, F., & Canalis, E. (2015). Management of endocrine disease: secondary osteoporosis: pathophysiology and management. European journal of endocrinology, 173(3), R131-R151.

Emkey, G. R., & Epstein, S. (2014). Secondary osteoporosis: pathophysiology & diagnosis. Best practice & research Clinical endocrinology & metabolism, 28(6), 911-935.

Casado, J. L., Bañon, S., Andrés, R., Perez-Elías, M. J., Moreno, A., & Moreno, S. (2014). Prevalence of causes of secondary osteoporosis and contribution to lower bone mineral density in HIV-infected patients. Osteoporosis International, 25(3), 1071-1079.

Adler, R. A. (2012). Laboratory testing for secondary osteoporosis evaluation. Clinical biochemistry, 45(12), 894-900.

Soriano, R., Herrera, S., Nogués, X., & Diez-Perez, A. (2014). Current and future treatments of secondary osteoporosis. Best Practice & Research Clinical Endocrinology & Metabolism, 28(6), 885-894.

Romagnoli, E., Del Fiacco, R., Russo, S., Piemonte, S., Fidanza, F., Colapietro, F., ... & Minisola, S. (2011). Secondary osteoporosis in men and women: clinical challenge of an unresolved issue. The Journal of rheumatology, 38(8), 1671-1679.

Papapoulos, S. E. (2011). Bisphosphonate therapy in children with secondary osteoporosis. Hormone research in paediatrics, 76(Suppl. 1), 24-27.

Diab, D. L., & Watts, N. B. (2013). Secondary osteoporosis: differential diagnosis and workup. Clinical obstetrics and gynecology, 56(4), 686-693.

Leidig-Bruckner, G., Raue, F., & Frank-Raue, K. (2012). Secondary osteoporosis-relevant clinical characteristics in diagnosis and therapy. Deutsche medizinische Wochenschrift (1946), 137(7), 326-332.

Yamamoto, M. (2013). Secondary osteoporosis or secondary contributors to bone loss in fracture. Bone metabolic disorders in patients with diabetes mellitus. Clinical calcium, 23(9), 1327-1335.