What is the diagnosis of Osteoporosis?

During a physical examination, your doctor may find that you are shorter than you thought you were or that you have a "dowager's hump," a curve of the spine in the upper back that produces a hump. X-rays may show that your bones are less dense than expected. While this could be caused by osteoporosis, there are other causes, such as not enough vitamin D.

Your doctor will suspect osteoporosis if you have had a fragility fracture. A bone density test can confirm the diagnosis. Several techniques measure bone density. The most accurate is DEXA (dual-energy X-ray absorptiometry). DEXA takes 10 to 15 minutes and is painless. It uses minimal amounts of radiation and generally is done on the spine and hip. A newer test, ultrasound bone density of the heel, is even quicker and less expensive, but it is not widely available or accepted as an accurate screening test for osteoporosis. Usually, people who are found to have osteoporosis by heel ultrasound eventually go on to have DEXA of the spine and hip.

Bone density tests can diagnose osteoporosis when the condition is mild and before fractures develop. This can lead to treatment that will prevent the condition from getting worse. In people with loss of height or suspicious fractures, bone density tests not only confirm the diagnosis of osteoporosis, but they also serve as a baseline for treatment and can be used to follow the response to treatment.

Additional blood and urine tests may be recommended to identify a cause of osteoporosis, such as a thyroid problem. However, for most people, no clear cause (other than age and being postmenopausal) is found.