Osteoporosis

What is osteoporosis?

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Lumbar spine x-ray image

Osteoporosis is a disease characterized by thinning and deterioration of bone tissue and loss of density. Osteoporosis can progress over time and cause the bone to become increasingly porous and weak and to break more easily. Healthy bone, viewed microscopically, looks somewhat like a honeycomb. In cases where osteoporosis is present, the holes and spaces in the honeycomb appear much bigger than those found in a healthy bone.

Women and older adults are more at risk for developing osteoporosis. Heredity and low body weight are also risk factors for the disease.

For those affected by osteoporosis, common occurrences such as lifting, bending, bumping into furniture and even sneezing can cause a bone to break. A fracture of the hip, spine or wrist is more likely to occur, but other bones are also susceptible to breaks.

Osteoporosis can be present for years without any noticeable symptoms, but signs can include:

  • Severe back pain
  • Loss of height over time
  • A stooped posture
  • Bone fractures from minor injury

How is osteoporosis evaluated?

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Lumbar spine x-ray image

To diagnose osteoporosis, assess your risk of fracture and determine your level of need for care, your doctor will most likely order a bone density scan (www.radiologyinfo.org/en/info.cfm?pg=dexa).

This exam is used to measure bone mineral density (BMD). It is performed through the use of dual-energy x-ray absorptiometry (DXA) or bone densitometry. The amount of x-rays absorbed by tissues and bone are measured by the DXA machine and correlate with bone mineral density.

DXA converts this information to your T score and Z score. The T score measures the amount of bone you have compared to younger people. It is used to estimate your risk of developing a fracture. Your Z score measures the amount of bone you have against those in your age group. This number can help indicate whether there is a need for further medical tests.

The following procedures can be performed to determine bone injury or fractures due to osteoporosis:

  • Bone x-ray (www.radiologyinfo.org/en/info.cfm?pg=bonerad): Bone x-ray produces images of bones within the body, including the hand, wrist, arm, elbow, shoulder, foot, ankle, leg (shin), knee, thigh, hip, pelvis or spine. It aids in the diagnosis of fractured bones, which are sometimes a result of osteoporosis.
  • CT scan of the body (www.radiologyinfo.org/en/info.cfm?pg=bodyct): CT scanning of the body can be used to measure bone mineral density and detect osteoporosis. Limited scans of the bones in the spine are performed and mathematical equations are used to calculate bone mineral density.
  • CT scan of the spine (www.radiologyinfo.org/en/info.cfm?pg=spinect): CT scanning of the spine is performed to measure bone density and determine whether vertebral fractures are likely to occur in patients who are at risk of developing osteoporosis. With the use of CT, the vertebrae, intervertebral disks and spinal cord are visible.

How might osteoporosis be treated?

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Lumbar spine x-ray image

Vertebral compression fractures in the vertebra can also occur as a result of osteoporosis. In these cases, vertebroplasty and kyphoplasty (www.radiologyinfo.org/en/info.cfm?pg=vertebro) may be an option to treat painful spine fractures. With vertebroplasty, image guidance is used to inject a special cement mixture through a hollow needle into the fractured bone. In kyphoplasty, a balloon is inserted through the needle into the fractured bone to create a cavity. Once the balloon is removed, a cement mixture is injected into the cavity.

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Locate an ACR-accredited provider: To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

This website does not provide costs for exams. The costs for specific medical imaging tests and treatments vary widely across geographic regions. Many—but not all—imaging procedures are covered by insurance. Discuss the fees associated with your medical imaging procedure with your doctor and/or the medical facility staff to get a better understanding of the portions covered by insurance and the possible charges that you will incur.

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Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, ACR and RSNA are not responsible for the content contained on the web pages found at these links.

Images: Images are shown for illustrative purposes. Do not attempt to draw conclusions or make diagnoses by comparing these images to other medical images, particularly your own. Only qualified physicians should interpret images; the radiologist is the physician expert trained in medical imaging.

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This page was reviewed on April 12, 2012

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