Yes. Osteoporosis can often be found before a bone breaks with a bone density test called a DXA or DEXA scan. The test uses a small amount of X-ray radiation to measure how dense certain bones are, usually in the hip and spine. Finding bone loss early can help a healthcare professional estimate fracture risk and discuss steps to lower it.
Osteoporosis develops when bones lose density and become weaker, making them more likely to break. It often causes no noticeable symptoms in its early stages, so someone may have the condition without knowing it. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), bone mineral density testing can detect low bone density before osteoporosis develops and help predict the risk of future fractures.
How is osteoporosis detected before a bone breaks?
The main test used to detect osteoporosis before a fracture is a bone mineral density test. The most common method is dual-energy X-ray absorptiometry, usually called a DXA or DEXA scan. It measures the amount of mineral in certain bones, providing information about bone density and helping a healthcare professional assess the likelihood of future fractures.
The MedlinePlus guide to bone density scans explains that the test can identify osteoporosis, detect low bone mass, estimate fracture risk, and monitor changes during treatment. It commonly measures the hip and lower spine because these are important sites for assessing bone strength and fracture risk.
What happens during a DXA scan?
A DXA scan is generally quick, painless, and noninvasive. You lie on a padded table while a scanning device passes over your body. The machine uses a low dose of X-ray radiation to measure bone density. A central DXA scan usually focuses on the hip and spine, and the appointment commonly takes around 10 to 30 minutes.
According to the NHS guide to DXA scans, a bone density scan is more effective than an ordinary X-ray for identifying low bone density. An ordinary X-ray may reveal bone changes or an existing fracture, but it is not the preferred test for detecting early bone loss. Your healthcare professional can determine which imaging test is appropriate for your situation.
Who should consider osteoporosis screening before a fracture?
Screening recommendations depend on age, menopausal status, medical history, and other factors that affect bone health. In the United States, the U.S. Preventive Services Task Force recommends osteoporosis screening for women aged 65 and older. It also recommends screening postmenopausal women younger than 65 who are assessed to have an increased risk of osteoporotic fractures.
The U.S. Preventive Services Task Force screening recommendation, updated in January 2025, states that evidence is currently insufficient to recommend for or against routine screening of men. This does not mean that men cannot develop osteoporosis or benefit from testing. Healthcare professionals can use individual risk factors and clinical judgment to decide whether a bone density assessment is appropriate. Recommendations may differ by country.
Testing may also be considered earlier than routine age-based screening when certain factors raise concern about bone loss. Examples include:
- Menopause, particularly when it occurs earlier than expected.
- Low body weight or a family history of osteoporosis or hip fracture.
- Long-term use of medicines associated with bone loss, such as certain corticosteroids.
- Medical conditions that can affect bone strength, including some hormonal or gastrointestinal disorders.
- Previous fractures following a fall or injury that would not usually break a healthy bone.
- Changes such as unexplained height loss that may prompt an assessment for spinal fractures or weakened bones.
These factors do not establish that someone has osteoporosis. They help a healthcare professional decide whether testing is useful and whether additional assessment is needed.
What do bone density scan results mean?
A bone density report describes how much mineral is present in the measured bones. The findings may indicate that bone density is within the expected range, lower than usual, or consistent with osteoporosis. Healthcare professionals interpret the results using appropriate measurements for the person's age and clinical circumstances rather than relying on the scan alone.
For many postmenopausal women and men aged 50 or older, the report may include a T-score, which compares bone density with a reference group of healthy young adults. A Z-score may be more appropriate for younger adults and children because it compares bone density with that of people of a similar age and other relevant characteristics.
According to NIAMS, bone mineral density measurements help clinicians evaluate bone health and fracture risk. The results are considered alongside medical history, previous fractures, medicines, and other relevant information. If the scan suggests low bone density, the healthcare professional can explain what the findings mean and whether further evaluation or preventive care is appropriate.
Can osteoporosis be found through other tests?
Other assessments can contribute useful information, but they do not all serve the same purpose as a DXA scan. A healthcare professional may review your medical history, measure your height, examine posture, or assess factors associated with fractures. Blood tests may be used to investigate conditions that contribute to bone loss, but routine blood tests alone cannot establish bone density.
In some cases, an X-ray taken for another reason reveals changes that raise concern about weakened bones. An X-ray may also identify a spinal fracture that was not previously recognized. The Mayo Clinic's guidance on osteoporosis diagnosis explains that osteoporosis may be identified during routine screening, after a broken bone is examined, or incidentally during imaging for another reason. When bone loss is suspected, a bone density test can help clarify the findings.
Why does early detection matter?
Finding osteoporosis before a fracture gives healthcare professionals an opportunity to assess fracture risk and consider suitable ways to protect bone health. Depending on the findings, this may involve reviewing contributing medical conditions or medicines, discussing nutrition and physical activity, reducing fall risks, or considering osteoporosis medication when clinically appropriate.
Early detection cannot guarantee that a fracture will never occur. Bone density is only one part of fracture risk, which can also be affected by age, falls, and other health factors. However, identifying bone loss before a fracture can help guide decisions intended to reduce the chance of future breaks.
If you have concerns about bone health or take medicines that may affect bone density, discuss screening with a healthcare professional. They can consider your medical history, age, and individual risk factors to determine whether a DXA scan or another assessment is appropriate.