If you have risk factors for osteoporosis it is important that you ask your doctor for a bone health assessment. 

As part of your bone health ‘check-up’ your doctor should take a complete medical history that includes information on any recent fractures. As well your doctor will likely estimate your future risk by using a fracture risk assessment tool such as FRAX^®. 

Depending on the results of your fracture risk assessment, a Bone Mineral Density (BMD) test may be recommended. In some countries (e.g. U.S.A.), BMD testing is recommended for all women and men at age 65, regardless of whether they have risk factors.

BMD testing is a safe, fast and painless method to measure whether you have osteoporosis or how likely you are to develop it in the future. 

Traditional X-rays used to identify broken bones (for example spine fractures) cannot measure BMD.  BMD has to be measured by more specialised techniques. Different types of BMD tests are available, but the most commonly used and recommended method is called DXA, which stands for dual-energy X-ray absorptiometry. DXA is a type of X-ray capable of detecting quite small percentages of bone loss. 

The T-score on your bone density report shows how much your bone mass differs from the bone mass of an average healthy adult in their twenties.

The T-score is measured in standard deviations (SD) and defines whether your bone mass is in the normal range, or whether you have osteopenia (an intermediate stage of bone loss between normal bone density and osteoporosis) or osteoporosis (a T-score of -2.5 or lower). 

If the results of your BMD test show osteopenia or osteoporosis, it does not automatically mean that you will have a fracture. There are lifestyle changes and a number of available therapies that your doctor might prescribe to slow down bone loss and help prevent fractures.

There are a number of other methods for diagnosing osteoporosis, however, these are most often used in clinical trials and research as opposed to routine diagnosis. These include radiological assessments and Bone Turnover Markers (BTM).