Nancy E. Lane, MD is an Associate Professor of Medicine at the University of California, San Francisco (UCSF). She is an established clinical investigator in musculoskeletal diseases with a special emphasis on osteoporosis and osteoarthritis. She is currently an NIH-funded investigator conducting a study to determine if PTH can reverse glucocorticoid-induced osteoporosis and to determine risk factors for the development and progression of hip OA. The purpose of this K24 award is to mentor and teach clinical research in osteoporosis and osteoarthritis at UCSF by 1) Developing an interdisciplinary clinical research seminars in osteoporosis and osteoarthritis that both topical lectures and work in progress research presentations by junior investigators; 2) Meeting individually with all junior clinical investigators UCSF in the field of osteoporosis and osteoarthritis to review research progress, provide study design analysis suggestions, and to establish additional resources for the investigators; 3) Becoming a core faculty member in the Master's in Clinical Research Program at UCSF by teaching a seminar on Developing a Clinical Research Protocol and mentoring master's students on research methodology; 4) Mentoring junior investigators in clinical research with my currently funded NIH grants on glucocorticoid-osteoporosis and on the epidemiology of hip OA. The specific aims of the currently funded NIH proposal to determine if PTH can reverse glucocorticoid-induced osteoporosis are to: l) To determine the changes in BMD caused by two years of treatment with hPTH (1-34) or placebo in postmenopausal women with GC-induced osteoporosis who are taking estrogen, calcium, vitamin D and chronic low doses of GCs; 2) To determine if estrogen or alendronate will preserve the high bone mass state created by two years of hPTH (1-34) treatment; 3) To determine the association of biochemical markers of bone turnover with hPTH (1-34) both during and after treatment. Monitoring for specific aim 3 will be accomplished by obtaining serum bone specific alkaline phosphates, serum osteocalcin, and urinary deoxypyridinoline cross-links at 3-month intervals; 4) To compare, as possible, the fracture incidence between the hPTH (1-34) and placebo treatment groups. Monitoring for specific aims I and 2 will be accomplished by annual spinal and proximal femur trabecular bone mineral content by quantitative computed tomography (QCT) and semi-annual dual x-ray absorptiometry (DXA) of the spine, hip, and forearm. The specific aims for the natural history of hip CA are to identify cases of new or worsening radiographic osteoarthritis (OA) of the hip by obtaining a second x-ray of the pelvis after an average of 8 years of follow-up in order to describe the natural history of radiographic hip OA and to determine the risk factors for hip OA. This Study of Osteoporotic Fractures cohort of elderly Caucasian women age - 65 have had radiographs of the pelvis obtained at baseline and after 8 years of follow-up in addition to bone mass measurements and other questionnaire and medication information. The data have been obtained and analyses are required. Dr. Lane has the enthusiastic support of her department of medicine and epidemiology at UCSF to pursue both her mentoring and continued research efforts in-patient oriented clinical research goals. She will strengthen her role senior mentor to young clinical investigators, she will teach clinical research methodology and develop a strong interdisciplinary clinical research group for musculoskeletal disease oriented research at UCSF.