Other investigations for osteoporosis

Bone density (DXA) scans and fracture risk assessments are most commonly-used by health professionals to diagnose osteoporosis, although there are a number of other scans and tests that may be used. Find out more below.

Computerised tomography (CT) scanning

This type of scanning uses x-rays and a computer to take pictures of bone and put images together.

CT scanners can be used to measure bone density and may be useful following compression fractures in the spine, when getting an accurate result on a bone density scan can be difficult. However, CT scanning uses higher levels of radiation than DEXA scanning, so a DEXA scan is usually considered preferable.

Bone markers

'Bone markers' are used to monitor the rate of bone loss in people with osteoporosis. They can tell whether bone is being lost too fast, and they may be used to monitor the body’s response to drug treatments. 

Bone markers work by measuring chemical traces that are left behind during the bone remodelling process, either in urine or blood. The test is only currently available in specialist centres when it is felt that the additional information provided could affect the type of drug treatment offered. Your GP will be able to advise whether a consultant referral is required.

Bone markers cannot be used alone to measure bone density or to assess the risk of a broken bone.

Download the bone markers factsheet for more information

Ultrasound scanning

An ultrasound scan is designed to look at bone structure and strength in a different way to bone density scanning, and usually examine the heel, wrist or finger.

Ultrasound can be used to examine structures inside the body. Sound waves of extremely high frequency, inaudible to the human ear, are beamed into the body. The echoes of reflected sound are used to build up an electronic image or measurement of the structure being examined.

Ultrasound scanning can certainly tell you something about your bone strength and risk of fracture, especially your risk of hip fracture if you are older (75 years or over), but it is not as well developed as other methods such as bone density scanning. If you have a low ultrasound result, you may need to be referred for a bone density (DEXA) scan, especially if you have other risk factors.

Bone biopsy

In a bone biopsy, a piece of bone is extracted and looked at under the microscope to detect changes inside the bone.

This is not a simple procedure and so is rarely used to investigate osteoporosis.