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Waiting until you break a bone is not the ideal way to detect osteoporosis. So if several of the risk factors mentioned earlier apply to you, including a family member with osteoporosis, discuss this with your GP.
If you appear to be at high risk of breaking a bone or have broken a bone after a relatively minor fall, you may be sent for a bone density scan.
The most common way to diagnose osteoporosis is to have a bone density scan. This uses a machine, known as a DXA (Dual energy X-ray Absorptiometry) scanner. To have a DXA scan you will need to wear loose clothing and lie on your back on a couch, while your hip and spine are scanned using low doses of radiation.
It takes about 10 - 20 minutes. Your bone density is compared with the average to produce a ‘T score’. A ‘T score’ of minus 2.5 standard deviations (SD) or less indicates osteoporosis.
Your scan results are looked at alongside other risk factors such as your age and family history. This helps decide if you are currently at a high risk of breaking a bone and whether drug treatment should be considered.
Before ordering a scan, your doctor may also use the World Health Organisation (WHO) FRAX® tool. This calculates your risk, over the next 10 years, of breaking a bone in your hip or other bone such as wrist, upper arm or a bone in your spine. This tool can be used for women after the menopause and for men over 50.
In January 2011, the National Institute for Health and Care Excellence (NICE) updated its guidance documents for the medical treatment of:
The guidance explains circumstances when drugs named in one or both guidance documents should and should not be used to prevent bone fractures.
As the drugs work best when you are getting enough calcium and vitamin D, you may be prescribed supplements. The guidance takes account of significant risk factors as well as bone density.
A patient version of this guidance is available on the NICE website.
This guidance does not apply to postmenopausal women who are on long-term steroids.
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