General Internal Medicine

Bone and Calcium Disorders

Questions discussed in this category

Do you recommend the use of albumin-adjusted calcium measurement formulas to accurately assess calcium levels?

Desgagnés et al., PMID 39836424

What is the optimal management of pain and loss of function due to pathologic compression fractures?

Assume no epidural/cord compromise. Is kypho/vertebroplasty, radiation therapy, or conservative management (brace, antiresorptive therapy) the superio...

1 Answer available

What treatment options would you consider for a young patient with limited mobility, low bone mass and multiple vertebral compression fractures who is on dialysis for advanced kidney disease?

1 Answer available

Would you expect cinacalcet to lower calcium levels in a patient with Familial Hypocalciuric Hypercalcemia (FHH)?

If a patient who has Familial Hypocalciuric Hypercalcemia (FHH) is misdiagnosed as PHPT (Primary Hyperparathyroidism) and treated with Cinacalcet, wil...

2 Answers available

What 24 hr urine calcium cut off value do you use for recommending parathyroidectomy in patients with asymptomatic hyperparathyroidism?

Changes in criteria for hyperparathyroid surgery. In the 2022 5th International conference on asymptomatic hyperparathyroidism, the experts have chang...

1 Answer available

Would elevated bone mineral density/T-score be enough to make a diagnosis of osteopetrosis?

1 Answer available

What is the likelihood of recovery of parathyroid gland function for patients who underwent total thyroidectomy, found to have embedded parathyroid glands intra-operatively and then subsequently had them re-implanted into neck muscle?

1 Answer available

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?

2 Answers available

Do you recommend parathyroid imaging testing for patients with recurrent nephrolithiasis who are incidentally found to have an elevated PTH but who do not have hypercalciuria, hypercalcemia, hypovitaminosis D, or chronic kidney disease?

2 Answers available

Would you add cholecalciferol or ergocalciferol to calcitriol therapy in patients with post operative hypoparathyroidism who have low 25 OH vitamin D levels?

Can 25 OH vitamin D be converted to activated vitamin D outside of PTH mediated mechanisms in some organs?

2 Answers available

What is your approach to progressive calvarial hyperostosis found in an elderly adult not caused by Pagets, acromegaly or hypercalcemia?

No evidence for acromegaly or Pagets.

1 Answer available

Given the risk of hypocalcemia in dialysis dependent patients treated with denosumab, what is the best method of treatment for osteoporosis for these patients, and should we be transitioning to a different agent?

2 Answers available

In patients presenting with classical findings of primary hyperparathyroidism (i.e mild hypercalcemia, high 24hr urine calcium, elevated 1,25 Vit D but normal PTH), can spontaneous normalization of calcium be explained by episodic hypersecretion of PTH?

1 Answer available

Does biotin interfere with the measurement of other metabolites of the Vitamin D pathway outside of the 25-hydroxy Vitamin D assay?

1 Answer available

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 ...

2 Answers available

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?

1 Answer available

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

1 Answer available

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?

1 Answer available

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

1 Answer available

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

1 Answer available

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

1 Answer available

Papers discussed in this category

World journal of surgery, 2004 Apr 19

Recovery of bone mineral density in 126 patients after surgery for primary hyperparathyroidism.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2018-10-05

CALCIUM CREATININE CLEARANCE RATIO IS NOT HELPFUL IN DIFFERENTIATING PRIMARY HYPERPARATHYROIDISM FROM FAMILIAL HERPERCALCEMIC HYPOCALCIURIA: A STUDY OF 1000 PATIENTS.

Genes, 2022 Oct 17

Hereditary Metabolic Bone Diseases: A Review of Pathogenesis, Diagnosis and Management.

JAMA, 2007-01-24

Risk of subsequent fracture after low-trauma fracture in men and women.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2017-07

Osteoporosis in Crisis: It's Time to Focus on Fracture.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2019 Dec 01

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition.

JAMA network open, 2022 Oct 03

Association of Multimorbidity and Excess Mortality After Fractures Among Danish Adults.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2022 Oct 17

The Economic Burden of Severe Osteoporotic Fractures in the French Healthcare Database: The FRACTOS Study.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020 Mar 16

Fracture risk following high-trauma versus low-trauma fracture: a registry-based cohort study.

The Journal of clinical endocrinology and metabolism, 2024 Jan 18

Cinacalcet Reverses Short QT Interval in Familial Hypocalciuric Hypercalcemia Type 1.

JAMA network open, 2025 Jan 02

Use of Albumin-Adjusted Calcium Measurements in Clinical Practice.

General Internal Medicine

Bone and Calcium Disorders

Questions discussed in this category

Papers discussed in this category

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