The evaluation of osteoporosis begins with a history and physical examination.

Physical findings in someone with osteoporosis may include:

• Loss of height
• Curving of the spine
• Difficulty walking

Blood tests that may be used to evaluate osteoporosis include:

• Serum calcium level
• Vitamin D level
• Dexamethasone suppression test
• Electrolyte profile
• Erythrocyte sedimentation rate
• Kidney profile
• Thyroid profile
• Parathyroid hormone level
• Testosterone level in men

Bone density testing is required to make the diagnosis of osteoporosis.

Bone tests that may be used to evaluate osteoporosis include:

• Bone mineral density:
• DEXA x-ray test measures the spine or hip
• Ultrasound measurement in the calcaneus (heel bone)
• CT scan measurement in the spine or hip
• Bone x-rays
• Bone scan

Individuals who should have bone mineral density testing include:

• All women older than 65 regardless of risk factors.
• Post-menopausal women with at least one additional osteoporosis risk factor other than menopause.
• Post-menopausal women who have had a wrist fracture, spine fracture, or hip fracture.
• Women considering therapy for osteoporosis, if testing would affect the decision.
• Individuals with primary hyperparathyroidism.
• Individuals with abnormalities of the spine:
• Kyphosis
• Ankylosing spondylitis
• Scoliosis
• Individuals receiving, or planning to receive, long-term glucocorticoids.
• Individuals being monitored to assess the response to an approved osteoporosis drug.