Metabolic Bone Disease

Clinical Highlights

Metabolic bone disorders are conditions that result in fractures or deformity of bones due to abnormal bone remodeling. The most common metabolic bone disease we see is osteoporosis.  We also provide care for patients with parathyroid disease, Paget's disease, hypophosphatemic disorders, hypophosphatasia, osteogenesis imperfecta and other rare bone disorders.

What services do we offer?

Our program is unique in that our bone densitometry (Dual Energy X-ray absorptiometry or DXA) program and reading of bone density are shared between endocrinology and radiology.

We partner closely with our colleagues in multiple departments:

  • Orthopedic Surgery to care for patients undergoing bone and joint procedures,
  • Sports Medicine to evaluate athletes with low bone density and/or fractures and a joint clinic with musculoskeletal radiology where we ensure patients who are referred for kyphoplasty for vertebral compression fractures undergo work up and treatment for osteoporosis. 
  • Our Endocrine Surgery colleagues  to provide expertise for patients with parathyroid disorders who seek surgical consultation.
  • We have helped to develop a Fracture Liaison Service with partners in Ambulatory Health Promotion as well as post hip fracture order sets with Orthopedic Surgery and Hospital Medicine to ensure adequate treatment for osteoporosis after hip fracture and other low trauma fractures.
  • We have several multidisciplinary clinics where we offer services in conjunction with Rheumatology and Musculoskeletal Radiology.
dr. rothmanSo many times when a low trauma fracture occurs, the underlying osteoporosis gets lost in the shuffle.  Our goal is to provide evaluation and treatment in a partnership with our patients to help them make informed choices about osteoporosis.
Micol Rothman, Professor of Medicine


Education Highlights

  • Monthly metabolic bone conference where providers from inside and outside the University present complex cases for discussion.
  • Metabolic bone clinic rotation for students, residents and fellows to see patients and learn about DXA interpretation. 

Research Highlights

My interest in metabolic bone disease stems from the patients that we treat.  A multi-disciplinary approach is necessary to optimize their overall bone health to keep them out of the hospital, allowing them to continue their usual activities. 
— Corey Ho, Assistant Professor of Radiology

Our Providers

Whitney Adair, PA Micol Rothman, MD 
Thomas Jensen, MD Virginia Sarapura, MD 
Sarah Mayson, MDDavid Saxon, MD 
Michael McDermott, MD Christine Swanson, MD, MCR 

Corey Ho, MD Alexandra Leo, PA 
Mary Jesse, MD  

The initiative to expand research in the Department of Orthopedics was driven by the vision of Dr. Bob D’Ambrosia and Dr. Evalina Burger and pivoted from the rich environment at the 4 CU campuses that include leading researchers in the bone and cartilage biology and skeletal tissue engineering fields.  This was a main draw for six new faculty to join over the past 2 years, including Drs. Cheryl Ackert-Bicknell, Doug Adams, Vanessa Sherk, Sri Iyer, Larry Moreland and Mike Zuscik.
– Mike Zuscik, Mack Clayton Professor, Department of Orthopedics

Recent PubMed Publications


Sleep Restriction With Circadian Disruption Negatively Alter Bone Turnover Markers in Women
Christine M Swanson, Steven A Shea, Wendy M Kohrt, Kenneth P Wright, Sean W Cain, Mirjam Munch 8, Nina Vujović  Charles A Czeisler, Eric S Orwoll, Orfeu M Buxton
PMID: 32364602 DOI: 10.1210/clinem/dgaa232 J Clin Endocrinol Metab 2020 Jul 1;105(7):dgaa232. doi: 10.1210/clinem/dgaa232.


COVID-19, Medical Education, and Bone Health: Insights From Project ECHO
E Michael Lewiecki, Micol S Rothman
Clin Densitom. 2020 May 8;S1094-6950(20)30081-0. doi: 10.1016/j.jocd.2020.04.003. PMID: 32448715 PMCID: PMC7207104 DOI: 10.1016/j.jocd.2020.04.003


Early-onset Paget's disease of bone in a Mexican family caused by a novel tandem duplication (77dup27) in TNFRSF11A that encodes RANK
Sean J Iwamoto, Micol S Rothman, Shenghui Duan, Jonathan C Baker, Steven Mumm, Michael P Whyte
2020 Apr;133:115224. doi: 10.1016/j.bone.2020.115224. Epub 2020 Jan 8. PMID: 31923705 PMCID: PMC7179970 (available on 2021-04-01)


Rapid suppression of bone formation marker in response to sleep restriction and circadian disruption in men
C M Swanson, W M Kohrt, P Wolfe, K P Wright Jr, S A Shea, S W Cain, M Munch, N Vujović, C A Czeisler, E S Orwoll, O M Buxton
Osteoporos Int. 2019 Dec;30(12):2485-2493. doi: 10.1007/s00198-019-05135-y. Epub 2019 Aug 24. PMID: 31446439 PMCID: PMC6879850 (available on 2020-12-01) DOI: 10.1007/s00198-019-05135-y Free PMC article


Bone mineral density and estimated hip strength in men with anorexia nervosa, atypical anorexia nervosa and avoidant/restrictive food intake disorder
Clin Endocrinol (Oxf) . 2019 Jun;90(6):789-797. doi: 10.1111/cen.13960. Epub 2019 Apr 1. PMID: 30817009 PMCID: PMC6615544 DOI: 10.1111/cen.13960 Free PMC article


Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials
Catherine M Jankowski, Pamela Wolfe, Sarah J Schmiege, K Sreekumaran Nair, Sundeep Khosla, Michael Jensen, Denise von Muhlen, Gail A Laughlin, Donna Kritz-Silverstein, Jaclyn Bergstrom, Richele Bettencourt, Edward P Weiss, Dennis T Villareal, Wendy M Kohrt
Clin Endocrinol (Oxf) . 2019 Feb;90(2):293-300. doi: 10.1111/cen.13901. Epub 2018 Dec 9. PMID: 30421439 PMCID: PMC6336516 DOI: 10.1111/cen.13901 Free PMC article


Lessons learned with Bone Health TeleECHO: making treatment decisions when guidelines conflict
M S Rothman, T P Olenginski, I Stanciu, K Krohn, E M Lewiecki
Osteoporos Int . 2019 Dec;30(12):2401-2406. doi: 10.1007/s00198-019-05147-8. Epub 2019 Aug 31. PMID: 31471665 DOI: 10.1007/s00198-019-05147-8


Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF)
C M Swanson, P J Blatchford, E S Orwoll, J A Cauley, E S LeBlanc, H A Fink, K P Wright Jr, M E Wierman, W M Kohrt, K L Stone
Osteoporos Int . 2019 Oct;30(10):2087-2098. doi: 10.1007/s00198-019-05007-5. Epub 2019 May 28. PMID: 31139855 PMCID: PMC6800619 (available on 2020-10-01) DOI: 10.1007/s00198-019-05007-5 Free PMC article


Dermal Calcium Loss Is Not the Primary Determinant of Parathyroid Hormone Secretion during Exercise
Wendy M Kohrt, Pamela Wolfe, Vanessa D Sherk, Sarah J Wherry, Toby Wellington, Edward L Melanson, Christine M Swanson, Connie M Weaver, Rebecca S Boxer
Med Sci Sports Exerc . 2019 Oct;51(10):2117-2124. doi: 10.1249/MSS.0000000000002017. PMID: 31009423 PMCID: PMC6746591 (available on 2020-10-01) DOI: 10.1249/MSS.0000000000002017 ree PMC article


Maintenance of Serum Ionized Calcium During Exercise Attenuates Parathyroid Hormone and Bone Resorption Responses
Wendy M Kohrt, Sarah J Wherry, Pamela Wolfe, Vanessa D Sherk, Toby Wellington, Christine M Swanson, Connie M Weaver, Rebecca S Boxer
J Bone Miner Res  2018 Jul;33(7):1326-1334. doi: 10.1002/jbmr.3428. Epub 2018 Apr 18. PMID: 29572961 PMCID: PMC6538281 DOI: 10.1002/jbmr.3428 Free PMC article


The importance of the circadian system & sleep for bone health
Christine M Swanson, Wendy M Kohrt, Orfeu M Buxton, Carol A Everson, Kenneth P Wright Jr, Eric S Orwoll, Steven A Shea
Metabolism . 2018 Jul;84:28-43. doi: 10.1016/j.metabol.2017.12.002. Epub 2017 Dec 9. PMID: 29229227 PMCID: PMC5994176 DOI: 10.1016/j.metabol.2017.12.002 Free PMC articlea


Bone Turnover Markers After Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans
Christine M Swanson, Steven A Shea, Pamela Wolfe, Sean W Cain, Mirjam Munch, Nina Vujovic, Charles A Czeisler, Orfeu M Buxton, Eric S Orwoll 
J Clin Endocrinol Metab. 2017 Oct 1;102(10):3722-3730. doi: 10.1210/jc.2017-01147. PMID: 28973223 PMCID: PMC5630251 DOI: 10.1210/jc.2017-01147 Free PMC article


Assessment and clinical management of bone disease in adults with eating disorders: a review
Anne Drabkin1, Micol S Rothman2, Elizabeth Wassenaar3, Margherita Mascolo1, Philip S Mehler
J Eat Disord. 2017 Dec 4;5:42. doi: 10.1186/s40337-017-0172-0. eCollection 2017. PMID: 29214023 PMCID: PMC5713040 DOI: 10.1186/s40337-017-0172-0 Free PMC article