There are different types of screening, including medical history, physical examination, bone mineral density (BMD) test, and laboratory testing. The medical history should focus on risk factors for low bone density, risks for falls, and heredity. Lifestyle choices should be assessed as well as, if female, menopause status.
The physical examination should include height and weight for body mass index (BMI) and determining any loss of height. A BMI of less than 21kg/m2 and a loss of more than 5 cm (or 2 inches) are both risk factors for osteoporosis.
BMD screening should ideally be performed using dual energy X-ray absorptiometry (DXA) to measure the hip and spine.
Laboratory testing should include: serum calcium, 25-hydroxy vitamin D, a complete blood count, and 24-hour urinary calcium excretion. Additional laboratory tests such as parathyroid hormone, thyroid-stimulating hormone, and serum protein electrophoresis may be indicated after the initial evaluation.
