What tests are used to detect a problem with bone?
Usually, bone problems are detected by taking x-rays or by measuring bone density (mass) using special types of X-rays. Bone problems can also be detected by ultrasound scans that use high-frequency sound waves.
Bone markers, which are signs of the bone turnover process, are sometimes used as an aid to bone density testing when doctors are evaluating whether or not you have a bone disease. The process involves measuring markers of bone resorption, such as the telopeptides and deoxypyridinolines, and markers of bone formation, such as bone-specific alkaline phosphatase (ALP) and osteocalcin. Bone resorption markers can be measured in blood or urine. Bone formation markers are measured in blood.
Most often, bone markers are used to monitor therapy for bone disease and to help your doctor determine if your body is responding to treatment. Bone markers can enable your doctor to tell if you are responding to bone-strengthening therapy in a much shorter time period than the X-ray types of bone density testing. This way, your therapy can be altered if you are not responding properly to it.
There is also some evidence that bone markers can help doctors to predict which breast and prostate cancer patients are at high risk for bone metastases. Bone markers may also be able to predict a patient’s response to therapy for a bone-loss condition.
When are these tests requested?
In some cases, bone markers are requested with other bone mineral density tests to diagnose a bone disease. Usually, however, bone markers are requested periodically to monitor patients who already have a diagnosed bone condition and who are undergoing therapy to see how well they are responding to treatment.