Diagnostic Tests for Osteoporosis

Diagnostic Test list for Osteoporosis:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Osteoporosis includes:

• Physical examination
  • Inspect for kyphosis (deformity of the spine characterized by excessive flexion) which causes a round shouldered appearance with a hump on the back. This is due to repeated minor fractures of the vertebra
  • Examine for signs of systemic disease that may increase the risk of osteoporosis - e.g. hyperthyroidism, Cushing's syndrome, diabetes mellitus, anorexia nervosa, Crohn's disease.
• Blood tests
  • Electrolytes, including calcium and phosphate levels (Calcium and phosphate levels are usually normal with osteoporosis; but elevated phosphate levels are common with hyperparathyroidism which increases the risk of osteoporosis)
  • Renal function tests
  • Creatinine ratio
  • Thyroid function test to detect hyperthyroidism which increase the risk of osteoporosis
  • Alkaline phosphatase level - Alkaline phosphatase is usually normal in osteoporosis. Elevated calcium and elevated.
  • Alkaline phosphatase without elevated PTH suggests bone metastases, Paget's disease and other bone tumor. Elevated calcium without elevated alkaline phosphatase suggests multiple myeloma and elevated protein due to other causes
  • PTH level - If increased this would suggest parathyroid tumor, parathyroid hyperplasia or ectopic PTH secretion. Elevated PTH levels increase the risk of osteoporosis.
  • Serum protein electrophoresis will help detect multiple myeloma which may need to be excluded
• Urine tests
  • Urinalysis
  • 24 hour urinary calcium level to detect elevated calcium due to elevated PTH levels
  • Protein electrophoresis will detect light chain (Bence Jones) proteins in Multiple myeloma which may need to be excluded
• Radiological investigations
  • Plain X-Rays are of limited value in detecting osteoporosis as it is not detectable until about 50% of the bone is lost
  • Bone densitometry can predict an increased risk of osteoporosis
  • Skeletal survey to detect bone lesions, if suspect Multiple myeloma which may need to be excluded
  • Bone scan, if suspect bone metastases or other bone tumors which may need to be excluded
  • Parathyroid ultrasound scan may detect larger parathyroid tumors which increase the risk of osteoporosis
  • CT Scan or MRI parathyroid are more sensitive with detecting parathyroid tumors
• Bone density tests
• Bone densiometry
• Quantitative ultrasound (QUS) of the heel
• X-rays - though x-rays are not that useful as they only detect osteoporosis in later stages.
• Dual photon x-ray absorptiometry (DXA)
• Other tests to detect osteomalacia - see tests for osteomalacia.

Home Diagnostic Testing

These home medical tests may be relevant to Osteoporosis causes:

• Osteoporosis & Bone Health: Home Testing:
  • Home Osteoporosis Tests
  • Home Bone Loss Tests
• Menopause: Related Home Testing:
  • Home Menopause Tests
  • Home FSH Hormone Tests
  • Home Osteoporosis Testing
• Vaginal Health: Home Testing:
  • Home Vaginal Infection Tests
  • Home Vaginal PH Tests
  • Home Yeast Infection Tests
  • Home Candida Kits
  • Home Urinary Tract Infection (UTI) Test Kits
  • Home Bladder Test Kits
• Breast Cancer: Related Home Tests:
  • Home Breast Cancer Test Kits
  • Home Breast Lump Detection

Tests and diagnosis discussion for Osteoporosis:

A family medical history and bone mass measurements are part of a complete assessment. Often a bone fracture is the first sign of osteoporosis. Ask your doctor to help you better understand your own risk and become aware of prevention and treatment options.

Routine x-rays can't detect osteoporosis until it's quite advanced, but other radiological methods can. The Food and Drug Administration (FDA) has approved several kinds of devices to estimate bone density. Most require far less radiation than a chest x-ray. Doctors consider a patient's medical history and risk factors in deciding who should have a bone density test. Readings are compared to a standard for the patient's age, sex and body size. Different parts of the skeleton may be measured, and low density at any site is worrisome. Bone density tests are useful for confirming a diagnosis of osteoporosis if a person has already had a suspicious fracture, or for detecting low bone density so that preventive steps can be taken. (Source: excerpt from Osteoporosis: NWHIC)

The most exact way to measure bone density is by a DEXA-scan (dual-energy x-ray absorptiometry). This is done on the whole body. Ask your doctor about this test if you think you are at risk for osteoporosis or if you are a woman around the age of menopause or older.

The DEXA-scan can show whether you are at risk for a fracture. If you have already broken a bone and your doctor thinks you might have osteoporosis, the test can confirm the diagnosis. If more than one test is done at least a year apart, your doctor can compare the test results over time. Then he or she can see if the treatment has succeeded in slowing your bone loss.

The test results are reported as a number. If your doctor says your result was –2.5 SD (standard deviation) or more, this means you have osteoporosis. A test finding of –1SD to –2.5SD means you have some bone loss. This is known as osteopenia, and you are at risk of developing osteoporosis. (Source: excerpt from Osteoporosis - Age Page - Health Information: NIA)

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