How Is Osteoporosis Diagnosed

Regular X-rays can detect osteoporosis of the bones. Bones would appear thinner and lighter than normal bones. However, the downside of using only x-rays is that by the time it is able to detect osteoporosis, 30 percent of the bones had already been lost. Apart from this, x-rays may not accurately indicate bone density since the appearance of the bones may be affected by variations in the degree of exposure in the x-ray film.

Major medical organizations such as the National Osteoporosis Foundation, the American Medical Association, among others, are recommending a dual energy x-ray absorptiometry scan (DXA, formerly known as DEXA) for diagnosing osteoporosis. DXA measures bone density of the hips and spine. DXA tests take about 5 to 15 minutes and use very little radiation (less than one tenth to one hundredth the amount used on a standard chest x-ray). DXA tests are very precise.

A patient’s bone density is then compared to an average peak bone density of young adults of the same sex and race. The result is called the "T-score". It expresses bone density in terms of the number of standard deviations (SD) below peak young adult bone mass.

Osteoporosis = bone density T-score of -2.5 SD or below.

Osteopenia = is bone density T-score between -1 and -2.5 SD. Osteopenia is between normal and osteoporosis.

Who should have bone density testing?

Osteoporosis is more common in women. The National Osteoporosis Foundation states that the following groups of women should consider DXA testing:

  • Postmenopausal women below 65 years of age who have risk factors for osteoporosis.
  • All women 65 years of age and older
  • Women with medical conditions associated with osteoporosis – there are about 50 known diseases associated with osteoporosis. Primary care physicians can examine a patient’s list of illnesses to confirm if one of these conditions is not present.
  • Women who decision to take medication might be aided by bone density testing.

Who need not have bone density testing?

  • People who have known osteoporotic fracture – he/she will be treated with or without bone density test results, as stated by the National Osteoporosis Foundation.

In addition to this, bone density testing should be done on people willing to take specific treatments based on the results.


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