A broken wrist after a simple stumble, a loss of height, or persistent back pain can sometimes be the first sign that bones have become weaker. This guide to osteoporosis screening explains how bone health is assessed, who may benefit from testing and how your GP can help you make an informed plan before a fracture occurs.
Osteoporosis is common, particularly as we get older, but it is not an inevitable part of ageing. It causes bones to become less dense and more fragile, increasing the chance of fractures from a fall that would not normally cause injury. The hip, spine and wrist are common fracture sites, and a fracture can have a major effect on independence, mobility and confidence.
Screening is not about assuming something is wrong. It is a practical way to identify risk early, so that lifestyle changes, treatment or further investigation can be considered when they are most useful.
Who may need osteoporosis screening?
Osteoporosis can affect women and men. The likelihood rises after menopause for women, when lower oestrogen levels speed up bone loss, and it also increases with age in men. However, age is only one part of the picture. Your GP will consider your overall health, medical history, medicines and any history of fractures.
A bone health assessment may be worth discussing if you are over 70, have gone through menopause, or are aged 50 or over with risk factors. A previous fracture from a low-impact event is particularly significant. For example, breaking a bone after falling from standing height, rather than during a major accident, may indicate fragile bones.
Other factors your doctor may consider include:
- a parent who had a hip fracture or a personal history of fractures
- low body weight, unplanned weight loss or poor nutrition
- smoking, regular high alcohol intake or low levels of weight-bearing activity
- long-term use of corticosteroid medicines, such as prednisolone
- conditions that affect hormones, nutrient absorption, kidney function or inflammatory health, including coeliac disease and rheumatoid arthritis.
Some people have no obvious risk factors and no symptoms until a fracture occurs. This is why it is sensible to raise bone health as part of a regular health check, especially if you are getting older or your circumstances have changed.
What happens during osteoporosis screening?
Osteoporosis screening usually begins with a GP consultation rather than a scan alone. Your doctor will ask about fractures, falls, family history, diet, physical activity, smoking, alcohol and current medicines. They may measure your height and weight, as gradual height loss can occasionally be linked with spinal compression fractures.
Your GP may use a fracture-risk assessment tool to bring these factors together. The result does not predict the future with certainty, but it helps determine whether a bone density scan or other action is appropriate. Risk assessment is individual. A healthy, active 62-year-old with no risk factors may need a different approach from a 55-year-old taking long-term steroid medication.
The bone density scan
The main test used to assess bone density is a dual-energy X-ray absorptiometry scan, usually called a DXA or DEXA scan. It is quick, painless and non-invasive. You lie still on a scanning table while the machine measures bone mineral density, most often at the hip and lower spine.
The radiation dose from a DXA scan is very low. There are generally no injections or special preparations required, although the imaging provider will tell you if you need to avoid calcium supplements shortly before the appointment. Wear comfortable clothing without metal where possible.
Your results may be reported using a T-score, which compares your bone density with that of a healthy young adult. A T-score can help classify bone density as within the expected range, low bone density or osteoporosis. It is not the only result that matters. Your age, medical history and fracture history remain essential when deciding what the result means for you.
Are blood tests part of screening?
Sometimes. If low bone density or osteoporosis is suspected, your GP may request blood tests to look for contributing causes or factors that can be treated. Depending on your situation, this may include checks of vitamin D, calcium, kidney function, thyroid function or other markers.
This is particularly useful when osteoporosis occurs earlier than expected, is severe, or follows a fracture without a clear explanation. Identifying an underlying cause can shape the best treatment plan.
When a fracture needs prompt attention
Do not wait for a routine screening appointment if you have had a fracture after a minor fall or bump. Arrange a GP review soon after the injury, even if the fracture has already been treated elsewhere. A low-trauma fracture can be a valuable warning sign and is associated with a higher risk of another fracture.
New or worsening mid-back pain, loss of height or a developing stoop should also be discussed with a doctor. These symptoms can have several causes, but spinal fractures are sometimes silent or mistaken for ordinary back pain.
Falls matter too. Bone density is only one side of fracture prevention. Reviewing balance, vision, footwear, home hazards and medicines that may cause dizziness can reduce the chance of a fall in the first place.
Understanding your results and next steps
A normal scan result is reassuring, but it does not mean bone health never needs to be reviewed. The timing of any repeat scan depends on your age, your result, new health conditions and whether you begin medicines that affect bone strength.
If your scan shows low bone density, your GP may focus on practical measures such as adequate calcium from food, vitamin D where needed, resistance exercise and weight-bearing activity. Walking, stair climbing and supervised strength training can support bone and muscle health, although the right activity depends on your fitness, balance and any existing fractures.
If osteoporosis is diagnosed or your fracture risk is high, medicines may be recommended to reduce the risk of future fractures. There are several options, and the best choice depends on factors such as kidney function, other health conditions, fracture history, convenience and potential side effects. Some treatments are tablets, while others are given by injection or infusion at different intervals.
Treatment works best when it is part of an ongoing plan. Your GP can monitor tolerance, arrange relevant tests, review falls risk and coordinate care with allied health professionals or specialists where appropriate. If you have been prescribed osteoporosis medicine, do not stop it without discussing this with your doctor, as treatment schedules and follow-up are important.
Medicare and referrals for bone density testing
Whether a DXA scan attracts a Medicare rebate depends on the reason for the test and the current eligibility criteria. A referral from your GP is generally needed, and your doctor can explain whether your circumstances may meet the requirements before you book.
Even when a scan is not immediately indicated, a consultation can still be worthwhile. Reviewing risk factors may identify changes you can make now, or establish when reassessment should occur. This avoids both unnecessary testing and missed opportunities for prevention.
Supporting stronger bones between appointments
Small, consistent habits can make a meaningful difference over time. Aim for regular weight-bearing and strengthening exercise that is safe for you, include calcium-rich foods in your usual meals, maintain a healthy weight and avoid smoking. Alcohol is best kept within Australian low-risk drinking guidance.
Vitamin D is important for calcium absorption, but supplements are not automatically right for everyone. Your GP can advise whether testing or supplementation is suitable based on your health, diet, sun exposure and medicines. People with osteoporosis or previous fractures should seek individual exercise advice before starting high-impact movements or activities involving repeated bending and twisting of the spine.
If you live in Keysborough or the surrounding south-eastern suburbs and are concerned about your bone health, booking a GP appointment is a sensible first step. A conversation now can help protect the movement, independence and everyday activities you value in the years ahead.
