Osteoporosis - Diagnosis

Diagnosis

Candidates for Bone Density Testing

Because osteoporosis can occur with few symptoms, testing is important. Bone density testing is recommended for:

• All women over age 65
• Postmenopausal women under age 65 with one or more risk factors for osteoporosis
• All men over age 70
• Men ages 50 - 70 with one or more risk factors for osteoporosis
• Any man or woman over age 50 who has suffered a fracture

Risk factors that may indicate a need for bone mineral density testing include:

• Long-term use of medications associated with low bone mass or bone loss such as corticosteroids, some anti-seizure medications, Depo-Provera, thyroid hormone, or aromatase inhibitors. Long-term use of corticosteroids (more than 5 mg/day for more than 3 months) is a specific risk factor.
• History of treatment for prostate cancer or breast cancer
• History of medical conditions such as diabetes, thyroid imbalances, estrogen or testosterone deficiencies, early menopause, anorexia nervosa, rheumatoid arthritis
• Significant loss of height
• Significant recent weight loss or low body mass index (BMI less than 21)
• History of hip fracture in parent
• Excessive alcohol use

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Tests Used for Measuring Bone Density

Central DXA. The standard technique for determining bone density is a form of bone densitometry called dual-energy x-ray absorptiometry (DXA). DXA is simple and painless and takes 2 - 4 minutes. The machine measures bone density by detecting the extent to which bones absorb photons that are generated by very low-level x-rays. (Photons are atomic particles with no charge.) Measurements of bone mineral density are generally given as the average concentrations of calcium in areas that are scanned.