Osteoporosis can be detected with bone density testing. First, the doctor will ask about your symptoms and medical history and perform a physical exam. If the doctor suspects you may have osteoporosis or you are at risk for osteoporosis, you may have one or more of the following tests:

Bone Mineral Density Tests

Bone mineral density (BMD) tests are painless, noninvasive tests that measure your bone mass. With a BMD test, your bone mass is measured and then compared to that of either (1) a healthy 30-year-old adult (T score), or (2) the expected bone mass of someone your age (Z score). Because low BMD is common among older adults, comparison to peers your age can be misleading. The results of a BMD test will indicate whether you have normal bone density, low bone density (osteopenia), or full-blown osteoporosis.

These test results, coupled with assessment of your risk factors for osteoporosis, will help you and your doctor decide which prevention or treatment options are right for you.

Types of BMD tests include:

Dual-energy x-ray absorptiometry (DXA)—a type of x-ray that measures bone density of the spine, hip, or total body (central DXA). This test can also be used to measure bone density at peripheral sites—wrist, heel, or finger (peripheral DXA).

Single-energy x-ray absorptiometry (SXA)—a type of x-ray that measures bone density in the wrist or heel

Quantitative ultrasound (QUS)—a test that uses sound waves to measure bone density in the heel, shinbone, and kneecap

Quantitative computed tomography (QCT)—a type of x-ray that uses a computer to measure bone density of the spine (central QCT). This test can also be used to measure bone density at the wrist (peripheral QCT).

Radiographic absorptiometry—an x-ray of the hand with a small metal wedge against which the width of the bone is compared.

Other Tests

Blood and urine tests—These tests check calcium levels and other substances created when bone is formed or broken down. These are called biochemical markers of bone turnover. Results indicate whether the process of bone breakdown in your body is occurring at a normal or at an excess rate.

Bone biopsy—done in certain cases to check for other causes of bone disease