Bone Density Test

Bone density test or bone densitometry is a radiological way to measure your bone density. 

Why measure bone density?

Bone density measures the strength of your bones and helps predict the chance that you'll sustain a bone fracture because of osteoporosis. 

The lower your bone density, the more likely you are to fracture a bone. 

A bone density test is helpful in telling you how your bone strength and mass measures up to other people in your age group. 

Bone Density Test

There are several ways to test bone density

Bone density can be measured by several different tests. 

A standard x-ray isn't a good way to measure bone density because your doctor can't see or detect any bone loss on the x-ray until you've lost at least 30 percent of your bone mass. Obviously, you need to know about bone loss long before you lose 30 percent. 

DXA test 
Dual Energy X-Ray Absorptiometry (DXA) is the most common bone density test people have. The DXA is the most widely used bone density test and is the one most insurance companies cover. 

A DXA scan typically measures the density of your lower spine and left hip. Some DXA scanners also measure the strength of your wrist. 

A DXA scan is painless, requires no advanced preparation, and is quite accurate. The only preparation is to not take calcium tablets the day before or the day of the procedure. 

SXA scan 
Single Energy X-Ray Absoptionmetry (SXA) measures the bone density in the forearm or heel. 

The SXA scan has many disadvantages including... 

  • The SXA test may not be as accurate as the DXA test.

  • The part being measured has to be submerged in water.

  • It takes longer to complete a SXA test.

  • Density bone tests in the heel may not correlate with bone density readings in your back.

However, the SXA test does have a couple advantages. The equipment for the test is portable and the cost for testing is low. 

Perpheral Dual Energy X-Ray Absorptiometry (PDXA) measures only peripheral sites such as the wrist, finger, or heel. This test also takes less time to complete than the SXA test. The equipment is portable but also higher than SXA. 

The PDXA also has the advantage of delivering a very low radiation dose and has a high resolution and high degree of accuracy. 

Radiographic Absorptiometry (RA) is known as photodensitometry. RA has the advantage of using standard x-ray equipment, but it requires specialized equipment that scans film at high resolution. RA also delivers a minimal amount of radiation. 

Peripheral Quantative Computed Tomography (pQCT) is a very accurate test that uses a CAT scanner with specialized software. This test is fairly accurate and expensive. This test results in a higher exposure to radiation and also takes longer to obtain the scan. 

The pQCT is the only test that measures cortical bone and trabecular bone in the forearm.

Deciding when to have a bone density test

It's recommended that the following people have a density test. 

  • All men aged 70 and older

  • Adults taking drugs for osteoporosis or medications associated with low bone mass or bone loss

  • Post-meopausal women under age 65 with risk factors such as family history of osteoporosis, weight less than 126 pounds, and smoking.

  • Anyone being considered for treatment

  • All women aged 65 and older

  • Anyone not receiving therapy where evidence of bone loss would lead to treatment such as a patient with previous diagnosed osteopenia now stopping estrogen replacement

  • Any adults with a history of a fragility fracture including hip, wrist, and spinal fracture with minimal trauma

  • All patients with evidence of reduced bone density on regular skeletal x-rays

  • Adults with a disease or condition associated with low bone mass or bone loss

› Bone Density Test

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