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Related Subjects: | Osteoporosis | Calcium & Bone Metabolism
Note: Reference sources may vary π. Biochemical patterns depend on severity and chronicity of disease, but the table below shows the classic exam-friendly profiles β .
Think about the big four markers: Calcium, Phosphate, ALP, and PTH. Vitamin D status helps tie the picture together. π Tip: In exams, look for a signature pattern rather than memorising numbers.
| 𦴠Bone disease | CaΒ²βΊ | POβΒ³β» | ALP | PTH | Vit D | π Key Clues |
|---|---|---|---|---|---|---|
| Osteoporosis | Normal | Normal | Normal | Normal | Normal | Structural weakness, not biochemical π¦΄.
Diagnosis via DEXA scan. |
| Osteomalacia / Rickets | β | β | β | β / N | β | Soft bones β fractures, Looserβs zones π. |
| Pagetβs Disease | N | N | β« Markedly β | N | N | Isolated very high ALP π. May have bone pain & deformity. |
| Myeloma | β | N / β | N (β if fracture) | N | N | Think CRAB π¦: βCa, Renal failure, Anaemia, Bone pain. |
| Bone Metastases | β | N / β | β | N | N | Lytic = low ALP, Sclerotic = high ALP.
Prostate β sclerotic βοΈ. |
| Primary Hyperparathyroidism | β | β / N | N / β | β | N | βStones, bones, groans, moansβ πͺ¨π¦΄π€―. |
| Secondary Hyperparathyroidism | β | β | β | β | β | Usually CKD or Vit D deficiency. Compensatory high PTH β»οΈ. |
| Hypoparathyroidism | β | β | N | β | N | Post-thyroidectomy β οΈ. Watch for tetany, Chvostek & Trousseau signs. |
| Renal Osteodystrophy | β / N | β | N / β | β | N / β | Part of CKD-MBD π§© (mineral bone disorder). |
| Vitamin D Deficiency | β | β | β | β | β | Classic cause of rickets/osteomalacia βοΈ. |
| Vitamin D Resistance (Rickets) | β | β | β | β | N | e.g. X-linked hypophosphataemic rickets π§¬. |
- Osteoporosis: structurally weak bone, biochemistry normal. - Osteomalacia: low Vit D β soft bone, high ALP. - Pagetβs: ALP very high in isolation. - Myeloma/Metastases: hypercalcaemia clues, look for CRAB π¦. - Parathyroid disorders: follow CaβPOβ balance (inverse). - Renal failure: phosphate retention, Vit D low, secondary hyperPTH. π In exams: spotting the **pattern** in labs is the fastest route to the answer.