Tests to check bone health

If you are having cancer treatment that is likely to affect your bones or you are generally at risk of weak bones, your doctor may do some tests.

Your doctor will ask you questions about your health and medical history to help assess your risk of bone problems. They may use online tests which can work out your risk of developing a fracture. The most common online tests are called FRAX and QFracture. The doctor enters relevant information, including your height and weight, into the online tool and it works out your risk.

A bone mineral density (BMD) scan uses x-rays to check the density of your bones. During the scan you will lie on a couch for a few minutes, you will have to keep still but the scan is painless.

After the scan you will be told that you have either normal density, low bone density (osteopenia) or osteoporosis. Having low bone density means you are more at risk of fractures. If the tests show that you have weak bones or osteoporosis, your doctor may advise you to take calcium or vitamin D supplements and make some changes to your diet.

Tests to check bone health

If you’re at risk of weakened bones, or if you’re having cancer treatment that is likely to affect your bones, talk to your GP or hospital doctors. They can do tests to check your bone health.


Fracture risk assessment tools

There are two online tools that doctors in the UK can use to see whether you’re at risk of a fragility fracture. These are called FRAX and QFracture. Your doctor may use one of these if you’re over the age of 40 and they’re concerned about your bone health or you have risk factors.

When your doctor uses the online tool, they’ll ask you questions about your health. They will ask you about your medical history and whether you have risk factors for osteoporosis or fragility fractures. They will also need to know your height and weight. Once the doctor has put your answers into the online tool it works out your risk of developing a fracture. The results will show whether you have a low, intermediate or high risk of a fracture.


Bone Mineral Density (BMD) scan

This is also known as a dual energy x-ray absorptiometry (DXA) scan. It checks the density of your bones. If your bone density is low, you have a higher risk of developing a fracture.

Your GP or hospital doctor may arrange for you to have a BMD scan if:

  • you’ve had a FRAX or QFracture assessment and it shows your risk of fracture is intermediate
  • you’re under 40 and have a significant risk of fracture – for example, you’ve had more than one fragility fracture, you’ve had a fracture due to osteoporosis, or you’re taking or have recently taken high doses of steroids
  • you’re a woman who hasn’t gone through the menopause and you have surgery to remove your ovaries as part of your cancer treatment
  • you’re a man with prostate cancer and you are going to start treatment with hormonal therapies that  reduce testosterone levels – if you are on long-term hormonal therapy you should have a BMD scan every year
  • you’re a woman with early invasive breast cancer and:
    • you’re going to start treatment with an aromatase inhibitor (for example anastrozole, letrozole or exemestane) 
    • you have an early menopause due to your treatment
    • you’re going to have treatment (with drugs, radiotherapy or surgery) to stop your ovaries working.

During the BMD scan, you’ll be asked to lie on your back on a couch while a scanner moves above your body.

The scan only takes a few minutes and is painless. You may be asked to put on a gown for the scan. You’ll also need to make sure there are no metal fastenings such as zips in the area of your body being scanned. Some people worry that the amount of radiation from a BMD scan may be harmful, but the amount used is much less than a normal x-ray.

The results of the scan will show whether you have a normal bone density, a low bone density (osteopenia) or osteoporosis.

If the result of your FRAX/QFracture assessment shows you have a high risk of fracture, or your BMD scan shows you have a low bone density or osteoporosis, your GP may advise you to take calcium and vitamin D supplements. They may do a blood test first to check the level of vitamin D in your blood. They may also prescribe a drug treatment, such as a bisphosphonate. They’ll also ask you to eat a healthy, balanced diet, get enough sunshine (if this is possible) and keep physically active.

Back to Bone health

Bone health

The human body is made up of more than 200 bones, it is important to keep them healthy.

Looking after your bones

There are changes that you can make to your diet and way of life to improve your bone health.