Inclusion Criteria:  Patients with 1ry OP diagnosed by DXA scan . Any RA and SpA patients (older than 18 years old), who fulfill the for mentioned diseases criteria with secondary osteoporosis as diagnosed by DXA scan.  Exclusion Criteria:  Patients unwilling to participate in the study. Patients with other autoimmune diseases. Patients depending on Glucocorticoids with in the last 6 month. Patients with other causes of 2ry OP (ex. Endocrinal abnormalities, Gastrointestinal diseases, Renal diseases…..etc.)