Making the Diagnosis
The first step in diagnosing osteoporosis involves evaluating your bone density. If the bone density is too low, you will be diagnosed with osteoporosis. There are several effective and relatively quick methods for measuring bone density.
Bone density measurement by a method called DEXA (dual energy X-ray absorptiometry) is the most effective way to assess the risk for osteoporosis. Scanning parts of the body such as the hips or spine using a special type of scanning machine that uses a minute amount of radiation can confirm that you have an increased risk of fractures. Computerized tomography (CT) or magnetic resonance imaging (MRI) scans can also be used to check the condition of the bones. The test compares your bone density to what would be expected of a healthy adult at age 25, the usual age of maximum bone density. That is called the "T-score."
A heel ultrasound test may also be used to test bone density and estimate the risk of fracture for women over 65 years of age. However, heel ultrasound does not provide enough detail to monitor treatment for osteoporosis. If you have a heel ultrasound that detects low bone density, talk to your doctor about having your bone density tested by DEXA.
Following the diagnosis of osteoporosis, further studies are needed to look for possible causes. An examination to determine such causes might involve blood and urine tests to measure the levels of calcium and vitamin D and certain hormones, such as parathyroid hormone and thyroid hormone, produced in the body, as well as questionnaires on lifestyle and diet, to determine, for example, one's daily intake of calcium and vitamin D.
People who have a family history of osteoporosis, those suffering from anorexia nervosa and other chronic diseases, and those taking medications such as corticosteroids (that increase the risk for this condition) are recommended to undergo bone density testing even if they have no symptoms. Bone density testing is conducted every one to two years for people already receiving treatment for osteoporosis, to check how the treatment is working. People taking corticosteroids for long periods of time require preventive treatment even if their initial DEXA test is normal.