Symptoms and Diagnosis of Osteoporosis
A bone fracture may be the first sign of osteoporosis.
Osteoporosis usually progresses without any symptoms, until a person fractures a bone, or one or more of their vertebrae (bones in the spine) collapse. Signs of collapsed vertebrae include severe back pain, loss of height, or a stooped or hunched posture.
Your doctor will conduct a medical evaluation to diagnose osteoporosis. This can include a medical history to determine risk factors for osteoporosis, physical exam (to see if you have lost height and to examine your spine), bone density test and lab tests.
When making a diagnosis of osteoporosis, your doctor will consider a number of factors, including:
- Your age
- Your gender
- Whether you have reached menopause (women)
- Whether you have broken any bones as an adult
- Your family history of broken bones and osteoporosis
- Your smoking or drinking habits
- Your diet, including how much calcium and vitamin D you get
- Your level of exercise and physical activity
- Whether you have had an eating disorder such as anorexia nervosa
- Whether you have had regular periods (premenopausal women)
- Your testosterone levels (men)
- Whether you take any medicines or have any medical conditions that may cause bone loss
A bone density test is used to diagnose osteoporosis. This test measures how strong your bones are. It can help predict your risk for developing a fracture.
The most common bone density test is a noninvasive, painless test called DXA (dual-energy x-ray absorptiometry), which uses low-dose x-rays to scan the hip and spine. You will lie on a soft table, while the scanner passes over your lower spine and hip. In most cases, you will not need to undress.
The results of the test are generally reported as a “T-score” and a “Z-score.” A T-score compares your bone density with that of healthy young women. A Z-score compares your bone density with that of other people of your age, gender, and race.
With both scores, a negative number indicates you have thinner bones than average. The more negative the number, the higher your risk of a bone fracture.
If your T-score is:
- -1.0 or above, you are within the normal range.
- Between -1 and -2.5, you may have early bone loss
- Below -2.5, you likely have osteoporosis
Blood and urine tests are not used to diagnose osteoporosis, but they can be used to identify other possible causes of bone loss.
All women ages 65 and older should be screened for osteoporosis, according to a panel of experts in primary care and prevention called the United States Preventive Services Task Force. Women ages 60 and older who are at increased risk for an osteoporosis-related fracture should also be screened.
If you are taking an osteoporosis medicine, your doctor is likely to recommend that you repeat your bone density test every one to two years. After you start a new osteoporosis medicine, you may be advised to repeat a bone density test after one year.