The National Osteoporosis Foundation recommends that all women ages 65 and older get bone mineral density testing regardless of their risk factors. Younger postmenopausal women with one or more risk factors and postmenopausal women who present with fractures should also get tested. But there is no clear consensus on how often women should be tested, with some experts recommending repeat testing at one-to-two-year intervals, and others suggesting less frequent testing. All postmenopausal women should be evaluated for osteoporosis risk to determine if they require bone mineral density testing, the NOF suggests. White women are considered to be at higher risk than other groups.
The presence of risk factors should be taken into account when determining whether to proceed with bone mineral density testing, which may be used to confirm or establish a diagnosis of osteoporosis or predict future fracture risk. But bone mineral density can only predict risk of developing a fracture; it can't establish certainty that a fracture will occur.
Options for bone mineral density testing include:
Dual X-ray Absorptiometry (DXA). Considered the gold standard of bone mineral testing, DXA tests can measure the spine, wrist, or hip. Getting a DXA of the hip or spine is preferred.
Ultrasound densitometry. Not as precise and doesn't seem to predict risk of fracture as well as other tests, reports the NOF. Can evaluate bone in the patella, heel, tibia, or other sites.
Peripheral Dual X-ray Absorptiometry (pDXA) and Single-Energy X-ray Absorptiometry (SXA). Measures bone density in the finger, forearm, and heel.
Quantitative computed tomography (QCT). A standard CT scanning machine is used in this method. But it's not commonly used because of greater cost and radiation exposure than the gold-standard DXA.