Sometimes referred to as the “silent disease,” osteoporosis often progresses without any symptoms and people are unaware they have osteoporosis until a fracture occurs. It is important to keep in mind that one in four people who experience a fracture die within a year following their fracture, so it is vital to maintain good bone health and know how a diagnosis of osteoporosis is made.
Osteoporosis is diagnosed through a combination of medical history, physical examination, and diagnostic tests.
Your doctor may ask you questions about your medical history, such as any previous bone fractures, family history of osteoporosis, your lifestyle habits, and any medications you are taking that may increase your risk of developing osteoporosis. Women aged 65 and above and men aged 70 or above are advised to be tested for osteoporosis.
Treatments for certain medical conditions deplete bone density and can increase your risk of osteoporosis. Some of these include treatments for breast cancer, prostate cancer, diabetes, and autoimmune diseases like multiple sclerosis. Certain habits such as smoking tobacco and drinking alcohol will increase your risk of developing osteoporosis. Make sure you share your full medical history with your doctor when discussing your risk of osteoporosis and bone fracture.
Your doctor may also perform a physical exam to assess your height, posture, and overall physical condition, as well as any signs of a curvature in the spine or other physical symptoms of osteoporosis.
There are three methods often used to diagnose osteoporosis:
- Bone mineral density: Osteoporosis is commonly diagnosed using a quick, painless, non-invasive test called a bone mineral density test. This method is used to diagnose osteoporosis prior to breaking a bone. The most common type of bone mineral density test is a dual-energy x-ray absorptiometry (DXA) scan. A DXA scan involves lying on a table and having a low radiation scan done over parts of the spine, hips, and occasionally arms. Following a DXA scan, you will receive what is called a T score. A T score between -1 and -2.49 results in a diagnosis of osteopenia, which is akin to being diagnosed as prediabetic as opposed to diabetic. A T score of -2.5 or lower results in an osteoporosis diagnosis. The lower your T score, the greater your risk of fracture.
- Fracture: A second way to make an osteoporosis diagnosis takes into consideration whether you have already broken a bone. Typically if a patient age 50 or older has already fractured their hip, spine, wrist, shoulder, or pelvis, they will be diagnosed with osteoporosis.
- FRAX®: A third way to diagnose osteoporosis involves using a simple calculation called FRAX®. FRAX® is an online tool developed by the University of Sheffield that combines bone density at the hip with “yes” or “no” answers to a series of risk factor questions impacting the quality of bone and risk of fracture. Following a DXA scan, FRAX® is also useful as a supplementary tool to determine a more comprehensive risk of fracture within 10 years. A FRAX® score of 3% or more indicates increased risk of hip fracture, and a score of 20% or above for major osteoporotic fracture.
Other tests that can help diagnose osteoporosis include a CT scan or MRI, which can detect fractures in the spine and measure bone density in other parts of the body.
Blood tests may also be performed to measure calcium and vitamin D levels, as well as other markers of bone health. These tests can help your doctor identify underlying medical conditions that may be contributing to your osteoporosis.
Following an osteoporosis diagnosis, it is essential that you take precautions to reduce your risk of falling and fracture. One way to maintain your peace of mind is wearing a comfortable hip protector.
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