Diagnosis of Osteoporosis
How is Osteoporosis Diagnosed?
If your doctor thinks you may be at risk for osteoporosis, he or she will review your medical history and do a physical exam. In addition, he or she will conduct other tests to assess your bone density.
Several tests are used to assess bone density. They are referred to as bone mineral density tests. There's simple, quick and painless test you can take that will tell you if you have low bone density. It's called DEXA or dual energy x-ray absorptiometry. It's an accurate test. Typically, your doctor will use it to look at the bone density in one of your wrists, one of your hips, and your spine. These are the places where osteoporosis is most likely to show up first. Your doctor can also use this test to follow changes in your bone density over time. Other tests that can be used to look at bone density include ultrasound and CT scanning. Medicare usually covers the cost of a bone density test for women aged 65 and older.
There are several lab tests for markers of bone turnover. These tests do not replace bone density tests but provide doctors with additional information on what may be causing bone loss. One of these tests involves measuring the amount of an enzyme, bone ALP or bone-specific alkaline phosphatase, in blood. This can tell your doctor how effective your medicine has been at increasing your bone density. Another marker for bone formation is osteocalcin, which is a protein found in blood. In addition, the presence of deoxypyridinolines and N-telopeptides in urine indicate that bone is being lost or reabsorbed by the body.
The National Osteoporosis Foundation recommends that women have their bone density tested based on the following factors:
- Over age 65, regardless of other factors
- Postmenopausal plus one other risk factor, including a bone fracture
- Abnormal spinal column
- Use of medicines that can cause osteoporosis
- Early menopause
The Foundation doesn't recommend screening for men because their risk is so much lower than women's risk.