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.
So 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
- Innovative research investigating novel modifiers of musculoskeletal adaptations to exercise and how exercise and hormones influence age-related skeletal changes
- Understanding the role sleep and circadian physiology play in optimal bone health.
- The Colorado Program for Skeletal Research encompasses a broad array of investigative activity: genetics of osteoporosis & scoliosis, bone biology, arthritis & joint biology, skeletal healing from the spine to limbs, stem cell biology & tissue engineering, growth plate injury & repair, brain injury-skeleton connections, and orthopedic pain management. Study in these contexts spans from the genetic to the organismal level --- from basic science investigations to clinical trials.
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
| Endocrinology | |
| Whitney Adair, PA | Micol Rothman, MD |
| Thomas Jensen, MD | Virginia Sarapura, MD |
| Sarah Mayson, MD | David Saxon, MD |
| Michael McDermott, MD | Christine Swanson, MD, MCR |
| Radiology | |
| 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 | |
| 1. | Sleep Restriction With Circadian Disruption Negatively Alter Bone Turnover Markers in Women |
| 2. | COVID-19, Medical Education, and Bone Health: Insights From Project ECHO |
| 3. | Early-onset Paget's disease of bone in a Mexican family caused by a novel tandem duplication (77dup27) in TNFRSF11A that encodes RANK |
| 4. | Rapid suppression of bone formation marker in response to sleep restriction and circadian disruption in men |
| 5. | Bone mineral density and estimated hip strength in men with anorexia nervosa, atypical anorexia nervosa and avoidant/restrictive food intake disorder |
| 6. | Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials |
| 7. | Lessons learned with Bone Health TeleECHO: making treatment decisions when guidelines conflict |
| 8. | Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF) |
| 9. | Dermal Calcium Loss Is Not the Primary Determinant of Parathyroid Hormone Secretion during Exercise |
| 10. | Maintenance of Serum Ionized Calcium During Exercise Attenuates Parathyroid Hormone and Bone Resorption Responses |
| 11. | The importance of the circadian system & sleep for bone health |
| 12. | Bone Turnover Markers After Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans |
| 13. | Assessment and clinical management of bone disease in adults with eating disorders: a review |