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Diagnosis of Osteoporosis

Osteoporosis can be detected with bone density testing. First, the doctor will ask about your symptoms and medical history and perform a physical exam. If the doctor suspects you may have osteoporosis or you are at risk for osteoporosis, you may have one or more of the following tests:

Bone mineral density (BMD) tests are painless, noninvasive tests that measure your bone mass. With a BMD test, your bone mass is measured and then compared to that of either a healthy 30-year-old adult (T score) or the expected bone mass of someone your age (Z score). Because low BMD is common among older adults, comparison to peers your age can be misleading. The results of a BMD test will indicate whether you have normal bone density, low bone density (osteopenia), or full-blown osteoporosis.

These test results, coupled with assessment of your risk factors for osteoporosis, will help you and your doctor decide which prevention or treatment options are right for you.

The types of BMD test used depends on why it is being done.

  • Tests for diagnosis of osteoporosis include:
    • Central dual-energy x-ray absorptiometry (DXA)—an x-ray that measures bone density of the spine, hip, or total body
    • Central quantitative computed tomography (QCT)—an x-ray that uses a computer to measure bone density of the spine
  • Tests for screening for osteoporosis include:
    • Central DXA or peripheral DXA—measures bone density at peripheral sites, such as wrist, heel, or finger
    • Quantitative ultrasound (QUS)—a test that uses sound waves to measure bone density in the heel, shinbone, and kneecap
    • Central or peripheral QCT—measures bone density at the lower arm, wrist, finger or heel

Blood and urine tests—These tests check calcium and vitamin D levels, and other substances created when bone is formed or broken down. Results indicate whether the process of bone breakdown in your body is occurring at a normal or an excess rate.

Bone biopsy—Done in certain cases to check for other causes of bone disease.

Revision Information

  • Bone density exam/testing. National Osteoporosis Foundation website. Available at: https://www.nof.org/patients/diagnosis-information/bone-density-examtesting. Accessed May 19, 2016.

  • Osteoporosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113815/Osteoporosis. Updated June 9, 2016. Accessed October 4, 2016.

  • Osteoporosis overview. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Osteoporosis/overview.asp. Updated June 2015. Accessed May 19, 2016.

  • Osteoporosis tests. American Academy of Orthopedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00413. Updated August 2007. Accessed May 19, 2016.