Diagnosis of Osteoporosis
An examination to diagnose osteoporosis can involve several steps that predict your
chances of future fracture, diagnose osteoporosis, or both. It might include:
• an initial physical exam
• various x rays that detect skeletal problems
• laboratory tests that reveal important information about the metabolic process
of bone breakdown and formation
• a bone density test to detect low bone density.
Before performing any tests, your doctor will record information about your medical history
and lifestyle and will ask questions related to:
• risk factors, including information about any fractures you have had
• your family history of disease, including osteoporosis
• medication history
• general intake of calcium and vitamin D
• exercise pattern
• for women, menstrual history.
In addition, the doctor will note medical problems and medications you may be taking that
can contribute to bone loss (including glucocorticoids, such as cortisone). He or she will
also check your height for changes and your posture to note any curvature of the spine
from vertebral fractures, which is known as kyphosis.
Risk Factors for Osteoporotic Fracture Include:
• personal history of fracture as an adult
• history of fracture in a first-degree relative
• Caucasian or Asian race,
although African Americans and Hispanic Americans are at significant risk as well
• advanced age
• being female
• dementia
• poor health, frailty, or both
• current cigarette smoking
• low body weight
• anorexia nervosa
• estrogen deficiency (past menopause, menopause before age 45, having both
ovaries removed, or the absence of menstrual periods for a year or more prior to
menopause)*
• low testosterone levels in men
• use of certain medications such as corticosteroids and anticonvulsants
• lifelong low calcium intake
• excessive alcohol intake
• impaired eyesight despite adequate correction
• recurrent falls
• inadequate physical activity.
*Women lose bone rapidly in the first 4-8 years following menopause, making them more
susceptible to osteoporosis.
X Ray Tests
If you have back pain, your doctor may order an x ray of your spine to determine whether
you have had a fracture. An x ray also may be appropriate if you have experienced a loss
of height or a change in posture. However, since an x ray can detect bone loss only after
30 percent of the skeleton has been depleted, the presence of osteoporosis may be
missed.
Bone Mineral Density Tests
A bone mineral density (BMD) test is the best way to determine your bone health. BMD
tests can identify osteoporosis, determine your risk for fractures (broken bones), and
measure your response to osteoporosis treatment. The most widely recognized bone
mineral density test is called a dual-energy x-ray absorptiometry or DEXA test. It is
painless: a bit like having an x ray, but with much less exposure to radiation. It can
measure bone density at your hip and spine.
During a BMD test, an extremely low energy source is passed over part or all of the body.
The information is evaluated by a computer program that allows the doctor to see how
much bone mass you have. Since bone mass serves as an approximate measure of bone
strength, this information also helps the doctor accurately detect low bone mass, make a
definitive diagnosis of osteoporosis, and determine your risk of future fractures.
BMD tests provide doctors with a measurement called a T-score, a number value that
results from comparing your bone density to optimal bone density. When a T-score
appears as a negative number such as -1, -2 or -2.5, it indicates low bone mass. The
more negative the number, the greater the risk of fracture.
Although no bone density test is 100 percent accurate, this type of test is the single most
important predictor of whether a person will fracture in the future.
Bone Scans
For some people, a bone scan may be ordered. A bone scan is different from the BMD
test just described, although the term “bone scan” often is used incorrectly to describe a
bone density test. A bone scan can tell the doctor whether there are changes that may
indicate cancer, bone lesions, inflammation, or new fractures. In a bone scan, the person
being tested is injected with a dye that allows a scanner to identify differences in the
conditions of various areas of bone tissue.
Laboratory Tests
A number of laboratory tests may be performed on blood and urine samples. The results
of these tests can help your doctor identify conditions that may be contributing to your
bone loss.
The most common blood tests evaluate:
• blood calcium levels
• blood vitamin D levels
• thyroid function
• parathyroid hormone levels
• estradiol levels to measure estrogen (in women)
• follicle stimulating hormone (FSH) test to establish menopause status
• testosterone levels (in men)
• osteocalcin levels to measure bone formation.
The most common urine tests are:
• 24-hour urine collection to measure calcium metabolism
• tests to measure the rate at which a person is breaking down or resorbing bone.
http://www.niams.nih.gov/bone/hi/osteoporosis_diagnosis.htm
An examination to diagnose osteoporosis can involve several steps that predict your
chances of future fracture, diagnose osteoporosis, or both. It might include:
• an initial physical exam
• various x rays that detect skeletal problems
• laboratory tests that reveal important information about the metabolic process
of bone breakdown and formation
• a bone density test to detect low bone density.
Before performing any tests, your doctor will record information about your medical history
and lifestyle and will ask questions related to:
• risk factors, including information about any fractures you have had
• your family history of disease, including osteoporosis
• medication history
• general intake of calcium and vitamin D
• exercise pattern
• for women, menstrual history.
In addition, the doctor will note medical problems and medications you may be taking that
can contribute to bone loss (including glucocorticoids, such as cortisone). He or she will
also check your height for changes and your posture to note any curvature of the spine
from vertebral fractures, which is known as kyphosis.
Risk Factors for Osteoporotic Fracture Include:
• personal history of fracture as an adult
• history of fracture in a first-degree relative
• Caucasian or Asian race,
although African Americans and Hispanic Americans are at significant risk as well
• advanced age
• being female
• dementia
• poor health, frailty, or both
• current cigarette smoking
• low body weight
• anorexia nervosa
• estrogen deficiency (past menopause, menopause before age 45, having both
ovaries removed, or the absence of menstrual periods for a year or more prior to
menopause)*
• low testosterone levels in men
• use of certain medications such as corticosteroids and anticonvulsants
• lifelong low calcium intake
• excessive alcohol intake
• impaired eyesight despite adequate correction
• recurrent falls
• inadequate physical activity.
*Women lose bone rapidly in the first 4-8 years following menopause, making them more
susceptible to osteoporosis.
X Ray Tests
If you have back pain, your doctor may order an x ray of your spine to determine whether
you have had a fracture. An x ray also may be appropriate if you have experienced a loss
of height or a change in posture. However, since an x ray can detect bone loss only after
30 percent of the skeleton has been depleted, the presence of osteoporosis may be
missed.
Bone Mineral Density Tests
A bone mineral density (BMD) test is the best way to determine your bone health. BMD
tests can identify osteoporosis, determine your risk for fractures (broken bones), and
measure your response to osteoporosis treatment. The most widely recognized bone
mineral density test is called a dual-energy x-ray absorptiometry or DEXA test. It is
painless: a bit like having an x ray, but with much less exposure to radiation. It can
measure bone density at your hip and spine.
During a BMD test, an extremely low energy source is passed over part or all of the body.
The information is evaluated by a computer program that allows the doctor to see how
much bone mass you have. Since bone mass serves as an approximate measure of bone
strength, this information also helps the doctor accurately detect low bone mass, make a
definitive diagnosis of osteoporosis, and determine your risk of future fractures.
BMD tests provide doctors with a measurement called a T-score, a number value that
results from comparing your bone density to optimal bone density. When a T-score
appears as a negative number such as -1, -2 or -2.5, it indicates low bone mass. The
more negative the number, the greater the risk of fracture.
Although no bone density test is 100 percent accurate, this type of test is the single most
important predictor of whether a person will fracture in the future.
Bone Scans
For some people, a bone scan may be ordered. A bone scan is different from the BMD
test just described, although the term “bone scan” often is used incorrectly to describe a
bone density test. A bone scan can tell the doctor whether there are changes that may
indicate cancer, bone lesions, inflammation, or new fractures. In a bone scan, the person
being tested is injected with a dye that allows a scanner to identify differences in the
conditions of various areas of bone tissue.
Laboratory Tests
A number of laboratory tests may be performed on blood and urine samples. The results
of these tests can help your doctor identify conditions that may be contributing to your
bone loss.
The most common blood tests evaluate:
• blood calcium levels
• blood vitamin D levels
• thyroid function
• parathyroid hormone levels
• estradiol levels to measure estrogen (in women)
• follicle stimulating hormone (FSH) test to establish menopause status
• testosterone levels (in men)
• osteocalcin levels to measure bone formation.
The most common urine tests are:
• 24-hour urine collection to measure calcium metabolism
• tests to measure the rate at which a person is breaking down or resorbing bone.
http://www.niams.nih.gov/bone/hi/osteoporosis_diagnosis.htm
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Osteoporosis
Protect your bone at every age...
Live Well, Live Strong, Live Long
Protect your bone at every age...
Live Well, Live Strong, Live Long