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Patient education: Bone density testing (The Basics)

Patient education: Bone density testing (The Basics)

What is bone density testing? — Bone density testing is a way for doctors to check how strong your bones are.

As people age, their bones often become less dense. This means that they are thinner and more fragile (figure 1). Over time, this can lead to a disorder called osteoporosis, which makes bones weak. People who have osteoporosis have bones that can break too easily. For example, people with osteoporosis sometimes break a bone during a minor fall that normally would not cause serious injury.

What is bone density testing used for? — Doctors do bone density testing for 2 reasons:

To see if a person has osteoporosis or is at risk for it

To see if treatments for osteoporosis are working

Who should get bone density testing? — All females age 65 and older should have bone density testing at least once. Bone density testing might also be appropriate for some males who are older than 70. Doctors sometimes check bone density in people who are younger than this if they are at high risk for breaking a bone. Things that increase your risk of breaking a bone include:

Having already broken a bone as an adult

Taking medicines called steroids for a long time

Weighing less than 127 pounds (58 kg)

Having rheumatoid arthritis

Having a parent who broke a hip after a minor injury

Are there different types of bone density tests? — Yes. The different types of bone density tests include:

Dual-energy X-ray absorptiometry ("DXA") – This is the most useful and reliable bone density test. It is a special kind of X-ray that gives off very little radiation. DXA gives reliable measures of bone density in different parts of the body, such as the spine, hip, and wrist. DXA is the best test to diagnose osteoporosis, predict the chances that you will break a bone, and check how well treatment is working.

Quantitative computed tomography ("CT") – This is another special kind of X-ray. It gives reliable measurements of bone density in the spine. It gives off more radiation than DXA. Doctors don't use this test to diagnose osteoporosis.

Ultrasound – Ultrasound can be used to measure the bone density of the heel. This test can help find out a person's risk of breaking a bone. But doctors don't use this test to diagnose osteoporosis or to follow changes in bone density over time.

What happens during a DXA test? — During DXA, you lie on a table. An X-ray machine scans 1 of your bones. The test doesn't hurt or make you uncomfortable. You don't need to take any pills or get any shots. The test takes 5 to 10 minutes.

Even though DXA is a type of X-ray, it gives off very little radiation. During DXA, you get about the same amount of radiation that an average person gets from the environment in 1 day. After the test, your bones get a "score."

What do the results mean? — The results of a bone density test are called "T" and "Z" scores. For males age 50 and older and for females who have gone through menopause (meaning they no longer have monthly periods), the T-score is more important.

Normal bone density – People with normal bone density have a T-score between +1 and -1. People who have a score in this range do not usually need treatment. Still, it makes sense for them do things to prevent bone loss. For instance, they should eat foods rich in calcium and vitamin D (figure 2), and get regular exercise.

Low bone density – This is also known as "osteopenia." It means the bone density is lower than normal, but not as low as it gets with osteoporosis. People with low bone density have a T-score between -1.1 and -2.4. They are at risk for developing osteoporosis. They usually need to do things to prevent bone loss. Sometimes, that means taking medicines. They should also eat foods with plenty of calcium and vitamin D, and get regular exercise.

Osteoporosis – People with osteoporosis have a T-score of -2.5 or less. If you discover that you have osteoporosis, there are lots of things you can do to lower the chances that you will break a bone. For instance, you can take osteoporosis medicines and calcium and vitamin D supplements. You can also exercise.

Do I need to have bone density testing again? — If your test shows that you do not have osteoporosis now, you might need to have the test again later. Ask your doctor or nurse if and when you should be tested again.

More on this topic

Patient education: Osteoporosis (The Basics)
Patient education: Paget disease of bone (The Basics)
Patient education: Dual-energy X-ray absorptiometry (The Basics)

Patient education: Bone density testing (Beyond the Basics)

Patient education: Osteoporosis prevention and treatment (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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