Diagnosis

How is osteoporosis diagnosed?

Osteoporosis is diagnosed with a bone density scan (also referred to as bone density test or bone mineral density test or by the medical name DXA test). It is a simple scan that measures the density of your bones at the hip and spine. You simply lie on a flat padded table, the arm of the machine passes over your body and the scan takes approximately 10-15 minutes. You remain clothed during the scan. Results from the test will be sent to your doctor.

Do I need a referral for a bone density scan?

Your GP or specialist will provide a referral for your bone density scan after assessing your risk factors for osteoporosis.

Where can I have a bone density scan?

Bone density scans are widely available through most medical imaging outlets (where breast screening, x-rays and ultra-sounds are also available), radiology centres, public hospitals and some specialist’s practices. A doctors referral is required for the scan.

Who should have a bone density scan?

Women and men over 50 with risk factors for osteoporosis need a bone check up with a bone density scan. Younger adults with risk factors may also require a test as determined by their doctor.

What will the scan tell me?

A bone density scan will determine if any action is needed to protect your bone health. The result will commonly refer to a ‘T-score’ and indicate if your bones are in the range of either:

• Normal
• Low bone density (called osteopenia) or
• Osteoporosis.

If your bone health is normal then maintaining adequate calcium, vitamin D and exercise remains important. If the result shows osteopenia or osteoporosis it is essential action is taken to protect your bones. Improvements in bone density and your bone health can be achieved over time.

T-score	Result	What does this mean?	Action required
-1 to -2.5	Osteopenia	This means you have lower than normal bone density. Action may be taken to protect your bone health depending on your age, the level of bone density and any risk factors for osteoporosis. The approach will be different if a fracture is present.	Your doctor will aim to reduce further bone loss, monitor your bone health with a follow up scan (1 – 5 years) and ensure adequate calcium, vitamin D and exercise. Your doctor will review any other health conditions or medications which can impact your bone health. If a fracture has occurred your doctor will commonly start treatment to reduce the risk of more fractures.
-2.5 or lower	Osteoporosis	Diagnosed osteoporosis requires immediate action as fracture risk is high.	Your doctor will commonly commence osteoporosis treatment to protect your bone health and reduce the risk of a first fracture (or further fractures if one has occurred). Your bone health will be monitored with regular scans (every 1 – 2 years). Your doctor will ensure adequate calcium, vitamin D and exercise together with your osteoporosis treatment.

Medicare rebates

Your doctor will advise if you are eligible for a Medicare rebate for your bone density. Medicare rebates for a bone density scan apply for:

• People with diagnosed osteoporosis
• Anyone with one or more previous fractures from a minor incident
• Corticosteroids use (common for asthma)
• Women with early menopause
• Men with low testosterone
• Individuals with coeliac disease (or other malabsorption conditions), overactive thyroid or parathyroid conditions, rheumatoid arthritis, liver or kidney disease
• those aged 70 years or over

Where rebates do not apply, patients with other risk factors can pay directly for a bone density scan. It is important you are tested as directed by your doctor.

Note: bone density scans emit a very low level of radiation (much less than a standard x-ray) and this is part of the reason a referral is required.

Warning: other types of bone tests available in some pharmacies or shopping centres such as Heel Ultrasound are not the recommended standard test to measure bone strength.