Your doctor will perform the following tests to determine your risk for osteoporosis:

Medical History and Physical Examination

During an osteoporosis examination, the doctor will take an inventory of risk factors, including

  • family history,
  • history of fractures,
  • menstrual history (women),
  • dietary history,
  • medications,
  • habits such as cigarette smoking and alcohol consumption,
and a review of past illnesses.

The physical exam includes an assessment of spinal tenderness and curvature, height measurement, and a search for signs of other medical conditions that may contribute to osteoporosis.

Laboratory Tests

Blood and urine tests may be required to identify conditions that can lead to osteoporosis. Blood tests include those that measure levels of calcium, thyroid-stimulating hormone, parathyroid hormone, the enzyme alkaline phosphatase, and vitamin D, as well as kidney and liver function. Calcium and cortisol may be measured in the urine.

When active bone resorption occurs in people with osteoporosis or Paget’s disease, the urine shows increased amounts of collagen byproducts—pyridinium cross-links and N-telopeptides—created by the breakdown of bone. Urine tests for these substances have been approved by the FDA and are commercially available, but their usefulness is not universally accepted.

Although tests for pyridinium cross-links and N-telopeptides are not required for a diagnosis of osteoporosis, they are useful in assessing a person’s response to therapy, because they can gauge response after just a few months of treatment. By comparison, it takes much longer to assess response to therapy using x-ray tests, which generally are not repeated until you have completed a full year of treatment.

Publication Review By: Lee H. Riley III, M.D., and Suzanne M. Jan de Beur, M.D.

Published: 18 Nov 2011

Last Modified: 05 Feb 2015