Some people refer to osteoporosis as a “silent” disease because it has very few symptoms. For this reason, testing is crucial to diagnose the condition. Diagnosis typically involves bone mineral density tests.

Osteoporosis is a condition that leads to porous, softened bones.

When it occurs, the body reabsorbs more bone tissue than it produces to replace it, which lowers the density of a person’s bones.

This article looks at the most common test for osteoporosis, what to expect during osteoporosis tests, when a person may need a test, and how to treat and prevent osteoporosis.

A person is getting a bone density scan.Share on Pinterest
Pascal Deloche/Godong/Universal Images Group via Getty Images

The most common test doctors use to diagnose osteoporosis is a bone mineral density (BMD) test. They can perform this in various ways using different equipment.

Dual-energy X-ray absorptiometry

The most common test that doctors use to measure BMD is a dual-energy X-ray absorptiometry (DEXA/DXA).

DEXA is a fast and painless, noninvasive test. It uses low X-ray levels as it passes a scanner over the body while an individual lies down.

This test measures the BMD of a person’s skeleton at various locations on the body, usually areas that are more prone to fracturing. This can include the spine or hips.

Doctors generally consider using a DEXA to measure a person’s bone density as the most reliable method of diagnosing osteoporosis.

Learn more about DEXA here.

Peripheral DEXA

Sometimes, a doctor may recommend a person have what healthcare professionals call a “peripheral DEXA” (pDEXA). A pDEXA measures the density of distal bones, such as in a person’s shin, forearm, heel, or wrist.

A pDEXA is portable, which can make it easier to use to perform screenings. However, the results of this test may not be as helpful as a DEXA in predicting a person’s risk for fractures in the future or monitoring the effects of any medications on the progression of the condition.

A person’s doctor will compare the results of their BMD test to the average bone density of other people with the same sex, age, and race as the individual. They will also compare them to a healthy young adult.

If a person’s BMD falls below a certain level, their doctor will typically diagnose them with osteoporosis.

Quantitative ultrasound

Sometimes, a doctor may recommend that a person undergo a quantitative ultrasound (QUS) of the calcaneus (heel bone).

A QUS is a test that evaluates bone to produce images without using radiation. However, it does not measure BMD. If a QUS test indicates that a person is experiencing bone loss, they will still need a DEXA in order for the doctor to deliver a diagnosis of bone loss and osteoporosis.

Doctors perform the different types of bone density tests in similar ways.


During a DEXA, a doctor uses a machine that can emit and detect X-rays. Depending on the mineral density of their bones, an individual’s bones will absorb different amounts of these rays.

A doctor can deduce how much X-ray radiation the person’s bones absorb during the test by comparing how much X-ray radiation the machine emits with how much of that radiation the machine detects on the other side of the person’s body. The doctor can then use this result to calculate a person’s bone density.


QUS scans work in a similar way to DEXA. Unlike DEXA, however, QUS scans use ultrasound to produce an image of a person’s bones rather than emitting and detecting X-rays.

Ultrasound scans use high-frequency sound waves to produce images of what is happening inside the body. These sound waves echo as they come into contact with a person’s bones.

Doctors will deliver the results of a person’s bone density test in the form of a “T-score.”

Doctors calculate a person’s T-score by comparing the density of their bones with the average bone density of a young person with the same sex assigned at birth as the individual.

According to a 2016 study, a T-score of -2.5 or less can be an indication that a person has osteoporosis.

Alongside BMD tests, a doctor may perform a physical exam to assess:

  • changes to a person’s posture
  • someone’s balance and gait
  • loss of height, weight, or both
  • muscle strength

In addition to this exam, a doctor will likely wish to discuss:

  • any history of fractures a person may have
  • someone’s lifestyle habits, such as:
    • diet
    • physical activity
    • alcohol use
    • smoking status
  • a person’s medical history and any conditions or medications that could cause low bone mass
  • any family history of osteoporosis
  • a person’s menstrual history, if applicable

While there is no evidence that it would be helpful for doctors to screen the general population for osteoporosis, a person should discuss screening for the condition with their doctor if they experience the following:

  • a history of at least one low-impact fracture
  • a body mass index (BMI) below 19
  • requiring steroid treatments for 3 months or longer
  • family history of hip fractures
  • a condition that can affect the bones, such as:
  • early menopause (before a person is 45 years old)

Learn more about the risk factors for osteoporosis here.

Treatment of osteoporosis aims to:

  • slow or prevent the development of the condition
  • prevent fractures
  • maximize quality of life
  • reduce pain

Following diagnosis, treatments a doctor may recommend include:

A person may wish to contact their doctor to discuss their treatment options.

Learn more about osteoporosis medications here.

While it may not be possible to completely prevent osteoporosis, there are steps a person can take to reduce their risk of developing the condition. These include:

  • getting enough vitamin D and calcium
  • avoiding smoking
  • limiting their alcohol consumption
  • performing weight-bearing exercises, such as walking, to help strengthen the bones
  • practicing exercises that develop flexibility and balance, as this can lower a person’s risk of falling and sustaining a fracture

Here are some more frequently asked questions about osteoporosis.

Can osteoporosis be detected by a blood test?

Sometimes a blood test can help diagnose bone diseases, including osteoporosis. This is because blood tests can identify risk factors, such as calcium levels in blood, and rule out other conditions.

How painful is a bone density test?

Bone density tests are typically quick and painless.

What are five symptoms of osteoporosis?

Osteoporosis symptoms include low-impact fractures and vertebral crush fractures of the spine. Symptoms of vertebral fractures include severe back pain, loss of height, or malformations of the spine, such as hunched-over posture.

Bone mineral density (BMD) testing is the most common and most accurate way to detect and diagnose osteoporosis. This may include tests such as dual-energy X-ray absorptiometry (DEXA/DXA), peripheral DEXA, and quantitative ultrasound.

Following diagnosis, a doctor will be able to recommend medical treatments and lifestyle changes to help a person manage symptoms and slow down the progression of the condition.