Evaluation and Treatment Options

The Metabolic Bone and Osteoporosis Center offers a variety of services and treatment options designed to prevent, diagnose and treat skeletal disorders. Experts in endocrinology, geriatrics, orthopedics and nursing collaborate and work with each patient and family to develop personalized treatment plans. It is our goal to offer patients a “one stop shop” when they come for appointments.

Our Center is unique in that it fosters the latest in research, technology and patient care in the area of metabolic bone diseases, or disorders of bone strength, commonly caused by abnormalities of minerals (such as calcium or phosphorus), vitamin D, bone mass or bone structure. Osteoporosis is the most common metabolic bone disorder, though there are many conditions that may lead to bone deterioration, fracture or other biochemical abnormalities that we see within our walls (see Conditions We Treat). With the realization that bone is not an inanimate object, the field is ever-changing with respect to how we think about bone remodeling and quality as well as how to best target what we learn each year so that our patients are best managed (lifestyle, pharmacotherapy, other).

Services and treatment options include the following:

  • Comprehensive osteoporosis assessments and expert evaluations of skeletal disorders
  • On-site DXA bone density scanning (spine, hip, forearm, vertebral fracture assessment, trabecular bone score) with a certified technologist
  • On-site bisphosphonate infusions (Reclast, Zometa)
  • On-site subcutaneous denosumab injections (Prolia)
  • On-site subcutaneous anabolic therapy injections (romosozumab / Evenity)
  • On-site anabolic therapy (teriparatide / Forteo, abaloparatide / Tymlos) teaching
  • On-site X-linked hypophosphatasia (XLH) therapy (burosumab / Crysvita)
  • On-site X-rays
  • Nutrition assessments
  • Balance and strength recommendations
  • Fall risk evaluation and prevention
  • Transiliac bone biopsy
  • Specialized imaging such as parathyroid sestamibi-SPECT and bone scans
  • Consultations with highly experienced endocrine, orthopedic, head and neck, and neuro-surgeons

Dual-energy X-ray Absorptiometry (DXA) Bone Density Scanning

DXA scan

Experts at the Metabolic Bone and Osteoporosis Center specialize in performing and analyzing DXA bone density scans. A DXA scan is safe, non-invasive and painless, and is one of the most accurate ways to diagnosis osteoporosis. It also is commonly used to perform instant vertebral fracture assessments and detect previously unrecognized spinal fractures.  The National Osteoporosis Foundation suggests that women over age 65, men over age 70 and anyone age 50 or older who has already had a fracture should undergo a DXA scan. It also is recommended for individuals with conditions that pre-dispose them to bone loss, such as hormonal prostate or breast cancer treatments, parathyroid or thyroid disorders, certain medications such as steroids, those with significant height loss, transplant patients and women who underwent menopause before age 45.

Our technologists have been certified by the International Society for Clinical Densitometry (ISCD) and are skilled in performing DXAs of the spine, hip and forearm to ensure accuracy and precision with each scan. Given that DXAs often assist clinicians in making a diagnosis, deciding on therapy, following treatment progress and monitoring patients off therapy (on “drug holiday”), it is critical that these scans be done properly. We take great pride in our high-quality scans and often transition patients to our machine to ensure the data from which we base decisions are accurate.

To schedule a DXA scan at the Metabolic Bone and Osteoporosis Center on the Johns Hopkins Bayview campus, please call 410-550-2565.