Who Needs an Osteoporosis Screening and How Is It Done?

An osteoporosis screening involves a review of risk factors and bone density testing. Bone mass naturally declines with age; however, osteoporosis is a severe loss of bone mass with a high risk of bone fractures. In some cases, if you catch excess bone loss early, you can prevent osteoporosis through proper treatment.

This article discusses screening for osteoporosis—what it involves, who should get it, what to expect, and how to interpret your results.

Osteoporosis Screening

Osteoporosis screening is part of bone density testing, which provides information about current bone mass. When performed at regular intervals, bone density tests can measure the rate at which you lose bone mass.

Types of Bone Density Tests

The most common bone density test type is central dual-energy X-ray absorptiometry (also known as a DEXA scan or DXA test).

DEXA scans occur in one of two ways:

• Centrally, which involves imaging bones in the lower spine and hip
• Peripherally, which involves imaging bones in the lower arm, wrist, fingers, or heel

Peripheral scans screen for osteoporosis and help determine whether or not follow-up central imaging should be performed.

Benefits of Early Detection

A decreased bone density that has not progressed to osteoporosis is called osteopenia. Early detection of decreasing bone mass offers many benefits. Most importantly, early treatment can help reverse bone loss before fractures occur.

Treatment for decreasing bone involves strength training and weight-bearing exercises that help make bones stronger. Calcium and vitamin D supplementations are also important for osteoporosis. If screening reveals that osteoporosis is already present, treatment may include medication.

Learn more: What You Need to Know About Osteopenia

Who Should Get a Bone Density Test?

There aren't any early symptoms of osteoporosis. Many people are unaware of this condition until they break a bone or notice changes in posture or height. Bone fractures from osteoporosis can occur during simple events, such as bending over or sneezing.

Women over 65 and men over 70 with no risk factors should get a DEXA, and women 50–64 with risk factors, such as smoking or steroid use, should also consider undergoing this test.

Risk Factors

Despite the absence of early warning signs, there are risk factors that increase the likelihood of developing this disease.

Risk factors for osteoporosis include:

• Age
• Sex
• Body type
• Family history
• Hormones
• Nutritional deficiencies
• Tobacco and alcohol use
• Physical activity

The risk of osteoporosis also increases with prolonged use of medications, such as:

• Corticosteroids
• Adrenocorticotropic hormone
• Cancer medications
• Seizure medications
• Proton pump inhibitors
• Thiazolidinediones
• Selective serotonin reuptake inhibitors

Certain medical conditions can also increase the risk of osteoporosis, including:

• Cancer
• HIV/AIDS
• Anorexia nervosa
• Gastrointestinal disorders
• Hormone imbalances
• Endocrine disorders
• Rheumatoid arthritis

Related: The Link Between Osteoporosis and Menopause

What to Expect?

Bone density tests are relatively short (around 30 minutes) and do not cause pain. There is minimal preparation needed before a DEXA scan.

How to Prepare

Dress comfortably but plan to remove anything that contains metal—such as underwire bras, jewelry, glasses, zippers, or buckles—before the test. You'll most likely be able to change into a gown or scrubs if needed.

During a bone density test, you will lay on your back with your legs supported by a pillow or foam block. While the scan is taking place, you'll need to hold still. In some cases, you might be asked to hold your breath briefly.

Understanding Your Results

Your healthcare provider assesses bone mineral density by comparing your results to those of an average or healthy young adult. Results are most often reported using a number called the T-score.

Your T-score represents standard deviations or the amount your score deviates from the average. The lower your T-score, the less bone mass you have. A T-score of 0 means that your bone mass equals the norm.

Results are interpreted in this way:

• Normal: T-score between +1 to -1
• Decreased bone mass: T-score between -1 to -2.5
• Osteoporosis: T-score -2.5 or lower
• Severe osteoporosis: T-score lower than -2.5 with one or more bone fractures

Bone density testing results can also be reported using Z-scores, which compare your measurements with someone of the same age.

Related: What Your Osteoporosis T-Score Says About Your Risk

Summary

Osteoporosis screening is important for the early detection of decreasing bone mass. There are no early symptoms of this disease, but screening can help identify your risk and prevent bone fractures that often occur as the disease progresses. Screening is performed using a bone density test—most commonly with dual-energy X-ray absorptiometry (DEXA scan).

If you have risk factors for osteoporosis, talk to a healthcare provider about scheduling a bone density test. The earlier you know you have osteoporosis, the sooner you can start taking steps to slow the disease's progression.