If I’m x-rayed for a broken bone, will osteoporosis, if I have it, show up on the x-ray? If it shows up on the x-ray, would I need further testing?
If you have advanced osteoporosis with significant bone loss, your x-rays may show osteoporosis. It usually takes about a 30% to 40% bone loss for osteoporosis to appear on conventional x-rays. Although x-rays are not used to diagnose osteoporosis, vertebral fractures are sometimes noted on conventional x-rays of the spine.
If you have a chest x-ray, for example for pneumonia, vertebral fractures might be found incidentally, meaning that you may not have complained about them but they are nonetheless present and seen on the chest x-ray. Vertebral fractures noted on any type of x-ray are usually an indication that you have some degree of bone loss; however, further testing is still required after the fracture heals.
The fact that you have fractured a bone, particularly if it was due to a small amount of force or from a standing height or less, is more important in considering whether you need further testing for osteoporosis . It is important to establish a baseline of bone mass so that future therapies and treatments can be monitored for their effectiveness.
Any individual who has a vertebral (a bone in the spine) fracture or hip fracture is at high risk for osteoporosis, and while the fracture should be healed first (because fractures can sometimes interfere with the accuracy of DXA testing), further bone mineral density testing is still necessary. In case you are treated for any fracture through an emergency department or through a specialist, you should always update your primary care clinician about your fracture so that further testing can take place if necessary.