Osteoporosis

Diagnosis of osteoporosis

If you have any of the above symptoms of osteoporosis, have a fracture, or are over the age of 50 and have a family history of osteoporosis, it is essential to see your doctor. Be prepared ahead of time to discuss your symptoms, medical history, and lifestyle. It’s also important to write down any questions you have ahead of your appointment.

If your doctor suspects osteoporosis or feels the need to monitor your bone density as you age, they will use a bone density test. The bone density test is a specialized x-ray that measures the amount of calcium and other minerals in your bone. It is entirely painless and noninvasive and requires you to lie still on a comfortable table while the scanning machine moves over your body.

Different types of bone density x-rays can be used. Central densitometers measure the density in the stabilizing bones of the body, namely the hips and spine. This is the most important type of machine for diagnosing osteoporosis. There are two types of central densitometers:

  • Dual-energy x-ray absorptiometry (DEXA) – The DEXA scan uses two x-ray beams to ensure more precision in the measurements.
  • Quantitative computerized tomography (QCT) – This is a type of computerized tomography (CT) scan that obtains x-ray images from all possible angles to provide a complete bone density picture. It is used in particular to get a proper density measurement of the vertebrae and the femur just below the hip joint.

The other type of bone density x-ray used is the peripheral densitometer. There are three types of this x-ray machine, including the quantitative ultrasound (QUS), peripheral dual-energy x-ray absorptiometry (pDXA), and peripheral quantitative computerized tomography (pQCT). These machines are designed to measure the density of the peripheral bones, such as those in the wrists and ankles.

It is recommended that all women age 65 or older have a bone density scan done regularly. If you are at low risk for osteoporosis and have not broken any bones, you may only need a peripheral scan. If this indicates low bone density, a central scan may be ordered. The central scan is also used to monitor your treatment if you have already been diagnosed with osteoporosis.

When you get your test results from your bone scan, it will be in the form of a T-score. This is a score that indicates your current bone density compared to the average bone density for someone of your age and gender. Here are the T-scores and what they mean:

  • -1 and higher – Normal bone density
  • -2.5 to -1 – Low bone mass that can lead to osteoporosis
  • -2.5 and lower – Osteoporosis

Keep in mind that if your test shows a low bone density, your doctor will want to go through your medical history, your family history, and your lifestyle to find possible causes and risk factors. This will most likely be accompanied by a physical exam and blood and urine tests, so that your doctor has a complete picture of your overall health.

Treatment

There is no cure for osteoporosis, but treatment and lifestyle changes can minimize bone loss and reduce the risk of complications, including fractures. Your doctor may recommend:

  • Low-impact, weight-bearing exercises such as walking, yoga, or riding a stationary bike. These exercises can help maintain bone mass, as well as increase overall strength, balance, and flexibility.
  • Diet rich in calcium and vitamin D to promote bone tissue formation. Calcium and vitamin D supplements are often necessary to reach the recommended daily values.
  • Diet rich in protein to ensure the building blocks of bone and muscle tissue are available. Protein can be obtained through healthy meat, plant sources, and supplements.
  • Limiting alcohol and not smoking, as both alcohol and tobacco cause more rapid bone loss.
  • Medications to slow bone loss and treat pain, including bisphosphonates, estrogens (hormone replacement therapy), and calcitonin.

Recovery

There is no cure for osteoporosis. Your treatment will be designed to manage the condition and slow the rate of bone loss, so you have the best quality of life possible. A lifestyle that includes a healthy diet and plenty of exercise will be a large part of managing your condition.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.