Osteoporosis: Screening for Bone Loss

The strength of bones is measured by their density (thickness). High bone density means bones are less likely to fracture. If you are at risk for bone loss, your health care provider may refer you for bone density testing.

Bone Density Testing

Woman putting hand and wrist in quantitative ultrasound (QUS) machine. Healthcare provider is operating machine.

Bone density testing is safe, quick, easy, and painless. It can detect osteoporosis before a fracture happens. It can also measure the response to treatment. There are several types of tests that you may have, including:

  • Central tests are used for screening and diagnosis. They measure density in the hip and spine. The main central test is the dual energy X-ray absorptiometry (DXA). The DXA is the standard bone density test.

  • Peripheral tests are used for screening. They measure density in the finger, wrist, knee, shin, or heel. A common peripheral test is the quantitative ultrasound (QUS). However, QUS screening is not as accurate or widely accepted as DXA screening. 

Who Should Be Tested?

  • All postmenopausal women under age 65, with one or more risk factors in addition to menopause.

  • All women age 65 and older.

  • Postmenopausal women with fractures.

  • Women who are thinking about treatment for osteoporosis.

  • Women who have been on hormone therapy for a long time.

  • Men or women with certain medical conditions or who are taking certain medications (such as glucocorticoids or prednisone) for a long period.

Common Testing Sites

Any bone can fracture, but with osteoporosis some bones fracture more easily. These include bones in the spine, wrist, shoulder, and hip. That’s why bone density testing may be done at one or more of these sites.

Understanding Your Results

The results of your test may seem confusing at first. Don’t be afraid to ask your provider to explain. Your health care provider will compare your bone mineral density (BMD) with the BMD of young, healthy bone. The result is called a T-score. Bones remodel at different rates. So, a healthy T-score in the wrist doesn’t mean the spine is also healthy. That’s why more than one site may be scanned.