Osteoporosis: Diagnosis

If you have osteoporosis—or are at risk for the condition—your doctor will start with a thorough assessment of your medical history and a physical examination. In addition, to confirm the diagnosis, the doctor will likely order a bone mineral density (BMD) test.

Bone mineral density test
The most common bone mineral density test is called a DXA test (a Dual Energy X-ray Absorptimetry test). This test uses a machine that measure the bone density in your hip and/or spine, and sometimes in other parts of your body. This exam is the only test that can diagnose osteoporosis before a broken bone happens. If you already know you have osteoporosis, this test may be repeated to monitor how well a bone-building medication is working.

Your doctor will pay careful attention to a number that you get from the DXA test called the T-score. This tells how your bones compare to those of a young, normal healthy adult.

  • A T-score of -1.0 or higher means you have normal bone density.
  • T-scores between -1.0 and -2.5 mean you have low bones mass (called osteopenia).
  • If your T-score is less than -2.5 or less, you have osteoporosis.

If you have osteoporosis, your doctor may recommend repeating your bone mineral density test every one or two years. It works best if you can get the test done in the same location (and on the same machine) each year so that you doctor can accurately compare the results.

Blood tests
Your doctor may also order special lab tests of the blood or urine to determine how fast you're losing bone or making new bone. And to check your calcium and vitamin D levels.

FRAX
Your doctor may use a Web tool called FRAX to determine how likely you are to break your hip or some other bone. It can also help your doctor decide if you need to take an osteoporosis medication.

X-ray
Osteoporosis can result in fractures in your spine that may lead to height loss or posture problems. As a result your doctor may order an x-ray if you have lost height recently, have back pain, or have a hunched posture.