Diagnosis and tests for osteoporosis

Osteoporosis is diagnosed by measuring bone density and assessing risk of fracture.

Main tests

• DEXA (DXA) scan: a low-dose X-ray of the hip and spine. The T-score tells you if bone density is normal, low (osteopenia) or in the osteoporosis range. It is the standard test.
• X-ray of the spine: can show compression fractures or loss of height
• Vertebral fracture assessment: a DEXA-based picture of the spine
• FRAX score: a calculator that estimates 10-year fracture risk

Blood and urine tests to find causes

• Calcium, phosphate and vitamin D (25-OH)
• Parathyroid hormone and thyroid tests
• Kidney and liver function, blood count
• Testosterone in men, and coeliac tests where suspected
• Sometimes bone turnover markers

Who should be tested

Women aged 65 and over, younger postmenopausal women with risk factors, men aged 70 and over, and anyone with a fragility fracture, long-term steroid use or a condition linked to bone loss.

Preparing for a DEXA

Do not take calcium supplements on the day. Wear clothes without metal. Tell staff if you had a recent barium or contrast test. Pregnant women should not have the scan.

Ayurvedic view

Ayurvedic assessment (Nadi, Prakriti or observation) does not measure bone density and cannot replace a DEXA scan.

See a doctor if you are not sure whether you should be tested.

When to get help

Speak with your doctor or an orthopaedic, endocrinology or rheumatology clinic if you have had a fracture from a minor fall, lose height, or develop a stooped back. Checking bone health early, with a DEXA scan where advised, lets you start the right plan before a break happens.

Remember

A painless 10-minute scan can show your bone health before a fracture occurs.