Exams and Tests

A diagnosis of osteoporosis is based on your medical history, a physical exam, and a test to measure your bone thickness (density). During a physical exam, your doctor will:

• Measure your height and compare the results with past measurements.
• Examine your body for evidence of previous broken bones, such as changes in the shape of your long bones and spine. See a picture of a compression fracture of the spine.

A bone mineral density test measures the mineral density (such as calcium) in your bones using a special X-ray or computed tomography (CT) scan. From this information, your doctor can estimate the strength of your bones. See a picture of a bone mineral density test.

Routine urine and blood tests can rule out other medical conditions, such as hyperparathyroidism, hyperthyroidism, or Cushing's syndrome, that can cause bone loss. In men, blood tests to measure testosterone levels can see whether low levels are causing bone loss.

If you have been diagnosed with osteoporosis, you may need to follow up regularly with your doctor to monitor your condition.

Early detection

If you or your doctor thinks you may be at risk for osteoporosis, you may have a screening test to check your bone thickness. A screening test may be advisable if you have:

• A fracture in a minor injury that may have been caused by osteoporosis.
• Another medical condition that is known to cause bone thinning.
• Risk factors for or symptoms that suggest osteoporosis.

The United States Preventive Services Task Force (USPSTF) recommends that all women age 65 and older routinely have a bone mineral density test to screen for osteoporosis. If you are at increased risk for fractures caused by osteoporosis, routine screening should start sooner.⁴ USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone mineral density screening.

The FRAX tool was developed by the World Health Organization to help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone mineral density test (BMD) on your hip, you can type in your score. If you have not had that test, you can leave the score blank.

Most experts recommend that the decision to screen younger women be made on an individual basis, depending on the risk for osteoporosis and whether the test results will help with treatment decisions. For help to decide whether you should be tested for osteoporosis, see:

Osteoporosis: Should I Have a Dual X-Ray Absorptiometry (DEXA) Test?

Experts suggest that older men talk to their doctors about osteoporosis and have bone mineral density tests done if they are at risk.⁵

Ultrasound is sometimes offered at events such as health fairs as a quick screening for osteoporosis. Ultrasound by itself is not a reliable test for diagnosing osteoporosis. But if results of an ultrasound screening find low bone density, your doctor can help you decide whether you should have a bone mineral density test.