At first, osteoporosis progresses unnoticed, but when bones break, especially in older people, it causes a heavy burden of illness (pain, being bedridden, sometimes permanent immobility).
The doctor first asks detailed questions about your medical history, symptoms and risk factors, and carries out a thorough physical examination paying particular attention to the skeleton. If necessary, X-rays of the thoracic and lumbar spine are taken. These may show typical signs of osteoporosis, for example deformed or fractured vertebrae.
Further information about the extent of bone loss is provided above all by bone density measurement (densitometry). According to the guideline of the DVO (German umbrella organisation for osteology), DXA bone density measurement should generally be carried out in all women over 70 and men over 80. In younger women and men, whether it is indicated depends on the individual osteological risk profile, which can be determined with a risk tool.
To rule out other diseases (secondary osteoporosis), blood and urine tests are carried out. Further X-rays, for example of the pelvis, skull and hand, laboratory tests or a tissue examination are only needed in individual cases.