How is it Diagnosed?
Osteoporosis is diagnosed based on bone mineral density (BMD) assessment and risk
factor evaluation. The most widely used method is the dual-energy X-ray
absorptiometry (DEXA or DXA) scan, which measures BMD at the hip and spine. Results
are reported as a T-score; a score of -2.5 or lower confirms osteoporosis, while a score
between -1.0 and -2.5 indicates osteopenia (low bone mass).
Clinical assessment includes a detailed history of fractures, family history of
osteoporosis, menstrual and menopausal status in women, and lifestyle factors such as
calcium intake, physical activity, smoking, and alcohol use. Physical examination may
reveal loss of height or kyphosis, suggestive of vertebral compression fractures.
Laboratory tests are performed to exclude secondary causes of osteoporosis such as
hyperparathyroidism, vitamin D deficiency, thyroid disorders, or chronic kidney disease.
These tests typically include serum calcium, phosphate, 25-hydroxyvitamin D,
parathyroid hormone (PTH), thyroid function tests, and renal function tests.
Fracture risk can be further quantified using tools like FRAX (Fracture Risk Assessment
Tool), which estimates the 10-year probability of a major osteoporotic fracture based on
clinical risk factors and BMD values.
Osteoporosis often remains undiagnosed until a fracture occurs, making early screening
in at-risk populations—especially postmenopausal women and elderly men—vital for
timely intervention.