Bone mineral density (BMD) testing -- as performed in dual-energy x-ray absorptiometry (DEXA) -- measures the demineralization of the bones. This has become the gold standard for evaluation for osteoporosis. BMD testing should be performed on all postmenopausal women with fractures, all women under 65 with an additional risk factor for osteoporosis (besides menopause), and all women 65 and over.
A spine CT can show demineralization. Quantitative computed tomography (QCT) can evaluate bone density, but is less available and is more expensive than DEXA.
A spine or hip x-ray may show fracture or vertebral collapse in severe cases.
Measuring the amount of calcium in your urine can provide some evidence of increased bone turnover, but is of limited value. A number of newer tests to evaluate bone turnover are becoming available, including measurement of urinary N-telopeptide (Osteomark). In the future, these may enhance your physician's ability to diagnose early osteoporosis.
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