It is possible to prevent osteoporosis from getting worse if it is diagnosed early. Many people don’t realize they have fractures until it is too late. Osteoporosis is a common age-related condition. Screening is strongly recommended for all people over 70 years old and for women over 65.
An osteoporosis assessment can determine if osteoporosis is due to natural aging (primary osteoporosis) or a separate issue affecting bone growth (secondary osteoporosis).
Evaluation of Osteoporosis Risk
Screening for osteoporosis involves a thorough medical history and physical exam to identify signs and symptoms and possible complications.
Medical history is a review of your health history to determine if you are at risk for osteoporosis (or secondary osteoporosis) in the future.
The physical exam is done to look for hyperkyphosis, a hunch, or emphasized curve in the upper back (thoracic spine). The lower back’s inward curve is greater, with the abdomen protruding inward with a decrease in overall body height.
Diagnostic Testing for Osteoporosis
Diagnostic testings may be ordered if a person is diagnosed with osteoporosis or has other symptoms.
These tests can be used to diagnose osteoporosis. They include assessing bone density, identifying fractures in the vertebrae, and identifying or ruling off secondary causes.
Dual-energy x-ray absorptiometry or DXA scan is the best way to diagnose osteoporosis. Also known as a bone density scan. This test measures bone density and is sensitive to changes in bone density that are associated with osteoporosis.
The DEXA scan is a simple procedure.
The patient lies down on their back on a table. The scanning arm is moved over the patient and emits a low dose x-ray into the lumbar spine, hip, or wrist. Some machines only have the detector and the x-ray source underneath the exam table. The computer calculates bone density by generating images from the scan.
T-scores are used to compare bone density with young adults. Z-scores compare bone density to an identical population. These results can indicate healthy bone density or significantly lower bone densities (osteopenia) and a higher risk of breaking (osteoporosis).
A DEXA scan’s purpose is to determine if a patient is more at risk for fractures due to low bone density. The scan is painless, and there is very little radiation exposure.
Vertebral imaging is done to confirm a vertebral fracture. A conventional x-ray is taken of the lower back (lumbar spinal), upper back (thoracic spine), and neck (cervical spinal). Vertebral imaging can also be used to detect any spinal fractures that may not be causing symptoms.
The lumbar and thoracic spines can be assessed for vertebral fractures. A bone mineral density test using a DEXA machine may also be done. This tool uses lower radiation exposure to take an x-ray image of the spine.