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Published on: 6/11/2024

How is osteoporosis diagnosed?

Diagnosis of osteoporosis is done by a bone mineral density scan (DEXA scan). Other tests that may be done include x-rays, blood and urine testing to look for an underlying cause of the osteoporosis.

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Explanation

Osteoporosis is diagnosed based on a bone mineral density (BMD) test. It may also be diagnosed based on either a history of a fragility fracture or an elevated risk of fracture risk (FRAX score). if you have ever had a fragility fracture in the spine, hip, wrist, humerus, rib, and pelvis. A fragility fracture is a bone fracture that happens from minor trauma that would not otherwise result in trauma.

BMD: The normal test for this is a dual-energy x-ray absorptiometry test (aka: DXA scan). This test uses low-dose x-rays to see they are absorbed differently by the bones. Your measurements are then compared against a standard to determine if your bone density is normal or below normal.

Fragility fracture: These are fractures of the spine, hip wrist, humerus, rib and pelvis that resulted from minor trauma (ie: fall from the ground) that normally would not result in a fracuture.

Risk Score: The FRAX score is a commonly used fracture risk calculator that may be used when the BMD is borderline. It includes risk factors for low bone density and fracture risk such as age, sex, height, weight, tobacco and alcohol use as well as current steroid use for other medical conditions.

Your health care provider will also do blood and urine testing to look for other causes of osteoporosis like thyroid dysfunction that could be treated to treat the bone loss.

In addition to medications to treat osteoporosis, maintaining a healthy weight, moderation of alcohol use, tobacco cessation and muscle-building resistance physical activity is important.

(References)

  • Ralston SH, Fraser J. Diagnosis and management of osteoporosis. Practitioner. 2015 Dec;259(1788):15-9, 2. PMID: 26882774.

  • Peacock-Johnson AM, Keresztes P. Osteoporosis: Diagnosis and management updates. Nursing. 2023 Dec 1;53(12):28-35. doi: 10.1097/01.NURSE.0000991592.29755.37. PMID: 37973009.

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