Osteoporosis develops slowly over the years. Symptoms such as tooth loss or back pain may be mistakenly attributed to something else. Anyone who has a family history of osteoporosis or risk factors for the disease should discuss their chances of getting it with a doctor. Some doctors have special training and experience that helps them diagnose and treat people with osteoporosis. These doctors include rheumatologists, endocrinologists and orthopaedic surgeons. Some general internists, radiologists and specialists in women’s health may also have special training in bone density measurement.
The doctor bases the diagnosis of osteoporosis on many factors, which are listed below.
Health History and Physical
The doctor will perform a physical examination and ask questions about the patient's personal and family medical history, medications, diet and fracture history.
Bood and urine tests can help rule out other diseases that weaken bones.
Bone Density Measurement
The doctor may recommend a bone density test. Bone-density tests should be done for:
- Women age 65 or over who are not taking bone-protecting drugs
- Individuals taking have taken long-term corticosteroids or expect to do so
- Individuals with a personal history or family history of fractures
- Individuals who have diseases that affect calcium absorption or bone strength
Bone-density tests may be recommended for some women as early as age 50 if they have a high risk for osteoporosis. Bone-density measurement is quick and painless. The most accurate test is called a dual-energy X-ray absorptiometry (DEXA) scan. It can measure as little as 1 percent to 2 percent loss of bone density. The DEXA scan also is used to track changes in bone density over time and with treatment.
Computerized tomographic (CT) scans also can measure bone density.
Bone X-rays are useful for finding fractured bones but are not accurate in determining bone density. X-rays cannot detect bone loss until there is a decrease of more than 30 percent.