The main purpose of this Manual is to provide useful guidelines for the selection of pathology tests and to facilitate interpretation of results.
Contains a comprehensive listing of all genes from the Human Gene Nomenclature Committee (HGNC) database alongside laboratories and tests available in the country.
A manual for the process of macroscopic dissection in Anatomical Pathology laboratories.
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Clinical assessment, including age, gender, presence of systemic disease.
See also Bone fracture (pathological).
Investigation may be appropriate to demonstrate increased bone loss prior to the development of clinical disease in high risk patients; to establish the diagnosis of osteoporosis; to monitor efficacy of treatment. Osteoporosis is diagnosed based on bone density (BMD) measurement and is defined as a BMD T score of £-2.5. Absolute fracture risk calculation is used to inform treatment decision http://garvan.org.au/promotions/bone-fracture-risk/calculator/
Other investigation may include diagnostic imaging to demonstrate fractures. Laboratory investigations may include Calcium, Phosphate, Albumin, Vitamin D, Alkaline phosphatase; fasting spot urine Calcium and, Creatinine , and bone turnover markers (BTM).
The recommended BTM are serum procollagen type I N propeptide (PINP) for bone formation and serum C-terminal cross-linking telopeptide of type I collagen (CTX) for bone resorption, which may be especially useful in monitoring treatment for which baseline and serial measurements are required. Urine deoxypyridinoline (DPD) or urine N-terminal cross-linking telopeptide of type I collagen (NTX) may be used as alternative bone resorption markers.
Bone loss commences prior to the menopause.
Plasma cell myeloma
See Amenorrhoea, Testicular failure.
Chronic metabolic acidosis, especially
Bone may also show osteomalacia/rickets and effects of hyperparathyroidism. Bone specific alkaline phosphatase (B-ALP) or intact PINP assays are least affected by renal impairment.
Paget's disease of the bone
Vasikaran S, et al. Osteoporos Int 2011;22(2):391-420
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The RCPA is the leading organisation representing Pathologists and Senior Scientists in Australasia.
Its mission is to train and support pathologists and senior scientists and to improve the use of pathology testing to achieve better healthcare.
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