The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Screening Tests

The main screening test for osteoporosis is called a bone mineral density (BMD) test. This is a painless, noninvasive method of measuring your bone mass. A BMD test can detect osteoporosis before a fracture occurs and can estimate your risk of having a fracture in the future.

With a BMD test, your bone mass is measured and then compared to that of either (1) a healthy 30-year-old adult (T-score) or (2) the expected bone mass of someone your age (Z-score). Because low BMD is common among older adults, comparison to peers your age can be misleading. The results of a BMD test will indicate whether you have normal bone density, low bone density (called osteopenia), or full-blown osteoporosis.

There are several types of BMD tests that are used to screen for or diagnose osteoporosis.

Screening Guidelines

Currently there is no consensus within the medical community regarding BMD screening tests. The decision whether to screen is usually made on an individual basis based on your risk factors. The National Osteoporosis Foundation suggests initial screening of the following postmenopausal women:

• All women age 65 or older, regardless of risk factors
• Postmenopausal women under age 65 with one or more risk factors for osteoporosis (beside menopause) such as:
  • Personal history of fracture as an adult
  • History of fracture in a first-degree adult relative
  • Current smoking
  • Weight less than 127 pounds
  • Postmenopausal women who present with fractures (to check for osteoporosis and determine the severity of the disease)
  • Women who are considering therapy for osteoporosis
  • Women who have been on hormone replacement therapy for prolonged periods

For older men, the American College of Physicians (ACP) recommends that your doctor assesses your risk factors for osteoporosis. The ACP also recommends that you have a dual-energy x-ray absorptiometry (a type of BMD test) done if you are at an increased risk and are a candidate for drug therapy.