Many conditions are associated with weakening of skeletal bone. Some represent osteoporosis or osteomalacia, but many combine both mechanism.
Groups:
(1) dietary
(2) hormonal
(3) malignancy-related
(4) drug-related
(5) mobility-related
(6) rheumatologic (autoimmune) disorders
(7) chronic liver disease
(8) gastrointestinal disorders
(9) neuromuscular disorders
(10) pulmonary disorders
(11) metabolic disorders
(12) hematologic disorders
(13) toxic exposure
(14) miscellaneous
Dietary
vitamin D deficiency |
osteomalacia |
chronic hypervitaminosis A |
osteoporosis (increased osteoclast activity and decreased osteoblastic) |
anorexia nervosa or bulimia |
mixed (osteoporosis, nutritional osteomalacia) |
lacto-vegetarian dieting |
osteomalacia (especially if high in phosphates and low in calcium) |
prolonged parenteral nutrition |
osteomalacia (nutritional, may include aluminum) |
malnutrition |
osteomalacia |
calcium deficiency or malabsorption |
osteomalacia |
phosphate deficiency or malabsorption |
osteomalacia |
rickets of prematurity |
osteomalacia |
Hormonal
hyperparathyroidism, primary (parapthyroid adenoma or hyperplasia) |
osteoporosis |
hyperthyroidism |
osteoporosis (stimulation of osteoclasts) |
Cushing's syndrome |
osteoporosis (decreased osteoblastic activity) |
senile, postmenopausal |
osteoporosis (hypogonadism) |
hyperprolactinemia |
osteoporosis (hypogonadism) |
Klinefelter's syndrome |
osteoporosis (hypogonadism) |
castratrion of ovaries or testes |
osteoporosis (hypogonadism) |
Turner syndrome |
osteoporosis (hypogonadism) |
acromegaly |
osteoporosis (with hypogonadism) |
growth hormone deficiency |
mixed (poor mineralization) |
Addison's disease |
osteoporosis (with excessive hydrocortisone replacement) |
diabetes mellitus |
mixed (renal osteodystrophy, drugs), increased falls risk |
pregnancy and lactation |
mixed |
hypoparathyroidism |
mixed (decreased osteoblastic activity; low calcium) |
Malignancy
leukemia |
osteoporosis (therapy, especially corticosteroids) |
systemic mastocytosis |
osteoporosis |
multiple myeloma |
osteoporosis (activation of osteoclasts, deactivation of osteoblasts) |
oncogenic osteomalacia |
osteomalacia (renal phosphate wasting) |
neurofibromatosis type I |
osteomalacia |
Drug-induced
glucocorticoid (see Cushing's disease) |
osteoporosis (see Cushing's) |
anticonvulsants (phenytoin, Phenobarbital) |
osteomalacia (multifactorial) |
heparin, high doses for > 3 months |
osteoporosis |
L-thyroxine replacement, excessive (see hyperthyroidism) |
osteoporosis (see hyperthyroidism) |
chronic lithium therapy |
osteoporosis (hyperparathyroidism) |
aromatase inhibitors |
osteoporosis (hypogonadism) |
chemotherapy |
osteoporosis (hypogonadism) |
depo-medroxyprogesterone acetate |
osteoporosis (hypogonadism) |
gonadotropin-releasing hormone (GnRH) agonists |
osteoporosis (hypogonadism) |
chronic use of phosphate binding antacids |
osteomalacia (low phosphate) |
extended use of tetracyclines |
osteomalacia (depression bone growth) |
diuretics causing hypercalcuria |
osteomalacia |
neuroleptic agents |
hypogonadism (secondary to hyperprolactinemia) |
cyclosporine A |
osteoporosis |
tacrolimus (FK506) |
osteoporosis |
drugs causing calciuria |
osteomalacia (loss of calcium) |
drugs causing calcium malabsorption |
osteomalacia (low calcium) |
radioactive iodine |
osteomalacia (hypoparathyroidism) |
thiazolidinediones |
osteoporosis |
SSRI antidepressants |
osteoporosis |
Mobility-related
immobility, prolonged bedrest |
osteoporosis |
space flight |
osteoporosis |
spinal cord disorders |
osteoporosis |
Rheumatologic disorder
SLE |
osteoporosis and osteomalacia (renal disease, drugs, systemic inflammation) |
rheumatoid arthritis |
osteoporosis (localized periarticular) |
juvenile polyarticular arthritis |
osteoporosis |
ankylosing spondylitis |
osteoporosis |
sarcoidosis |
osteoporosis (hypercalcemia) |
epidermolysis bullosa |
osteoporosis |
Chronic liver disease
primary biliary cirrhosis |
mixed osteoporosis and osteomalacia (hepatic osteodystrophy) |
hemochromatosis |
osteomalacia (hypoparathyroidism, hepatic osteodystrophy) |
primary sclerosing cholangitis |
mixed osteoporosis and osteomalacia (hepatic osteodystrophy) |
alcohol abuse |
mixed (nutritional osteomalacia,; osteoporosis from hypogonadism, estrogen excess) |
Gastrointestinal disorders
celiac disease |
osteomalacia (malabsorption) |
Crohn's disease |
ICD-10InfoSpecialty: Surgery, orthopedic, Endocrinology, Nutrition ICD-10: , |