During a physical exam, your doctor may find that you are shorter than you thought you were. Or, your doctor may notice a "dowager's hump." This is a curve of the spine in the upper back that produces a hump.
X-rays may show that your bones are less dense than expected. This could be caused by osteoporosis. But there are also other possible causes, such as not enough vitamin D. Vitamin D deficiency is common. It is easy for your doctor to diagnose.
Your doctor will suspect osteoporosis if you have had a fragility fracture.
A bone density test can confirm an osteoporosis diagnosis. Several techniques measure bone density.
The most accurate bone density test is DEXA (dual-energy X-ray absorptiometry). DEXA takes 10 to 15 minutes and is painless. It uses minimal amounts of radiation and generally is done on the spine and hip.
A newer test is ultrasound bone density of the heel. It is even quicker and less expensive than DEXA. But it is not widely available or accepted as an accurate screening test for osteoporosis. Usually, people who are found to have osteoporosis by heel ultrasound eventually go on to have DEXA of the spine and hip.
Bone density tests can diagnose osteoporosis when the condition is mild and before fractures develop. This can lead to treatment that will prevent the condition from getting worse.
In people with loss of height or suspicious fractures, bone density tests confirm the diagnosis of osteoporosis.
They also serve as a baseline for treatment. They can be used to follow the response to treatment.
Additional blood and urine tests may be recommended to identify a cause of osteoporosis, such as a thyroid problem. However, for most people, no clear cause (other than age and being postmenopausal) is found.