What You Need to Know About Bone Density Testing

A bone density test is used to diagnose osteoporosis and assess your risk of fracture.

Every year an estimated 2 million people break a bone due to osteoporosis. In fact, roughly 50 percent of women over the age of 50 will likely fracture their hip, spine or wrist over the course of their life, which can be not only painful, but also debilitating.

Your doctor may recommend bone density testing to assess your risk of fracture. By knowing your fracture risk, you can take steps to prevent future fractures. Here’s what you need to know about bone density testing.

Why bone density testing is important
A bone density test measures bone loss. The less dense your bones, the greater your risk of fractures. Primarily, a bone density test is done to definitively diagnose osteoporosis or osteopenia, a precursor to osteoporosis. Bone density testing is also used to help determine bone loss due to conditions like rheumatoid arthritis (RA), inflammatory bowel disease, diabetes, chronic liver disease and hyperthyroidism.

In addition, bone density testing is used to assess if treatment is working and if your bone density is improving, staying the same or worsening. The National Osteoporosis Foundation recommends getting a DXA scan every one to two years after starting osteoporosis medication to measure how well the treatment is working.

Who should get tested
All women over age 65 and men over age 70 should get a bone density test. Younger women and men should consider bone density testing if they:

  • Smoke
  • Drink heavily (more than three drinks per day)
  • Have low body weight
  • Used corticosteroids for three months or more
  • Broke a bone during a minor incident after turning 50, or have a parent who broke a hip
  • Have low levels of vitamin D

If you had early menopause or are menopausal and have other risk factors for osteoporosis, you may want to ask your doctor if a bone density test is right for you.

What to expect during a bone density test
A bone density test is non-invasive, painless and lasts about 15 minutes. The standard bone density test is called a dual energy x-ray absorptiometry (DXA or DEXA) scan. During this test, you lie either partially or fully clothed on a padded table while an x-ray generator takes pictures of your hip and spine. These two areas are the main focus of the test because the bone density of your hip and spine can accurately predict your likelihood of breaking another bone in your body. The DXA scan then compares your bone mineral density to the expected bone mineral density of a healthy young adult to determine your fracture risk and confirm whether or not you have osteoporosis. If you are unable to lie on the table, there is a variation that measures the forearm bones instead of the spine and hip.

During the scan you are exposed to a very small amount of radiation, so if you are or may be pregnant, let your doctor or x-ray tech know.

If your results indicate osteopenia or osteoporosis, your doctor may prescribe osteoporosis medication to help prevent fractures.

Keep your bones strong
Everyone can benefit from building strong bones. Here are a few simple steps you can take to keep your bones healthy:

  • Eat well: Eating foods rich in calcium as well as vitamins C, D and K is key to building strong bones.
  • Hit the gym: Weight bearing exercises, like walking and jogging, as well as resistance exercises, like lifting weights, stimulate the growth of new bone tissue.
  • Quit smoking: Studies have found a link between smoking and significant bone loss. Quitting reduces bone loss and the risk of fractures.

Medically reviewed in November 2018.

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