Sierra Endocrine Associates

Endocrinology, diabetology & Metabolism
Joseph B Hawkins, Jr. MD, FACE

Serving the San Joaquin Valley

7230 N Millbrook Ave

Fresno, CA 93720


Societies Issue Joint Guidance for Osteoporosis Management During the COVID-19 Pandemic

In a joint statement,1 a coalition of experts representing the American Society for Bone and Mineral Research, American Association of Clinical Endocrinologists, Endocrine Society, European Calcified Tissue Society, and National Osteoporosis Foundation issued guidance on the management of osteoporosis during the coronavirus disease 2019 (COVID-19) pandemic.

Osteoporosis Center

What is Osteoporosis?
Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

In the U.S., 10 million individuals are estimated to already have osteoporosis. One in 5 women over the age of 50 will experience a bone fracture within her lifetime. An osteoporotic fracture is more likely than Breast, Uterine, and Ovarian Cancer combined.

Fortunately, osteoporosis can be prevented and treated. Sierra Endocrine Associates can conduct a bone mineral density test that can identify if you are at risk. We can also recommend changes in your diet and lifestyle and the use of newer medications to help improve your bone mass and prevent fractures.

Advanced Densitometry
Dr. Hawkins of the Sierra Endocrine Associates was the first to bring state of the art osteoporosis diagnosis to the Central Valley in January of 1991. At that time, he installed the first Dual Energy X-ray Bone Densitometer capable of measuring bone density of the spine, hip, and wrist individually, as well as with the entire body. Bone densitometyr is a painless radiological test to assess osteoporosis risk and aid in determing patients risk for fracture.

In the summer of 2019, Sierra Endocrine Associates added the latest in densitometry technology, the Hologic Bone Densitometer. This state of the art device allows us to take a lateral view of the spine, similar to a vertebral x-ray, and at the same time measure the bone density. Previously unrecognized vertebral fractures must be identified prior to treatment recommendations.

Trabecualar Bone Score
The bone densitometry scan measures on aspect of of your bone strenth – the bone mineral density.  The other crucial aspect of bone strength is teh bone micro-architecture. The TBS-Insight software is advanced technology that can provide indirecet measure of this important and valuable information expressed by the Trabecular Bone Score (TBS).

Sierra Endocrine Associates is the first to bring  the latest addition to Bone Densitomitry and osteoprosis fracture risk assessemnt with new software analysis of bone structure,  which is included in every scan we do.


National OsteopoRosis Foundation Partner



At Sierra Endocrine Associates we  hold firmly to the principle that our greatest asset is the ability to listen to the needs of our patients. Each member of our team is committed to delivering care in a compassionate, patient-centered environment. You will meet with a member of our team who will take a thorough history of your heath, review available testing and information and explain the process  for going forward.


At Sierra Endocrine Associates we  perform bone densitometry use the latest dual energy x-ray absorptiometer, (DEXA or DXA) measuring the lumbar spine, both hips and when needed the wrist. In addition every patient also has a Vertebral Fracture Assessment and a Trabecular Bone Score. All of these measures help to evaluate an individual fracture risk profile to aid in decision making regarding treatment. In addition to the DXA services we have a comprehensive laboratory where any needed lab testing can be done on site.



After a thorough evaluation treatment options, risks, benefits and side effects of medications are discussed and then  recommendations are made. We are very fortunate to have a number of effective FDA approved treatment ranging from oral to injectable to intravenously administered medications. Some medications must be given by a health care professional and we are able to offer all therapies at Sierra Endocrine Associates with insurance permission.


At this time no cure for osteoporosis is available so  once diagnosed treatment can be expected to be for many years.  Like many chronic conditions adjustments in treatment may be needed. We will meet with you once or twice a year to review your condition and responce to treatment. Using periodic repeat DXA and lab testing we can determine if the treatment is haivng the deisred effects as well as monitor for any side effects or adverse reactions.