Do you need a bone density test? This X-ray scan of your hip, spine, and wrist will tell you how strong your bones are—or if you’re at risk for osteoporosis, the bone-thinning disease that can lead to painful and disabling fractures. But do you need the exam? You do if you’re over age 65—or 50 with a previous bone fracture or risk factors for osteoporosis.
A bone density test, called a Dexa scan, is a painless procedure that measures the mineral content of your bones. You’ll get a result that indicates whether your bones are normal, have low bone mass (a condition known as osteopenia), or are significantly below normal, which is osteoporosis.
The importance of strong bones
Your bones are constantly changing as new bone replaces old bone. A problem arises when you lose bone more quickly than is replaced, weakening your bones and making them susceptible to fractures.
When you have osteoporosis, even a minor fall can break a bone. There are 1.5 million fractures each year in the United States caused by osteoporosis, including fractures of the spine, hip, and wrist—the most common areas affected by the condition.
And they can be devastating. For example, half the people who break a hip never are able to walk again without some type of assistance. Many people with osteoporosis need long-term care.
Because osteoporosis doesn’t usually have symptoms until you unexpectedly break a bone, the bone density test can spot thinning bone (osteopenia) before it develops into osteoporosis.
Although osteoporosis can affect men and women, it’s primarily a disease of women, especially after menopause when women lose estrogen, the hormone that helps the body maintain bone density.
Other risk factors include: having had a fracture as an adult; being thin; having a family history of osteoporosis; being a long-term smoker; having an inactive lifestyle; not getting enough calcium; going through menopause before age 45; being Caucasian or Asian, or having used steroids for a long time.
You and your doctor will use the information from the bone density test to decide what treatment, if any, you may need and what preventive steps you can take.
According to the National Osteoporosis Foundation, you can prevent osteoporosis by getting enough calcium and vitamin D and eating a well-balanced diet; exercising regularly; eating more fruits and vegetables; not smoking; and limiting alcohol to a couple of drinks a day.
If you have osteoporosis, your doctor may recommend an osteoporosis medication, such as biphosphonates, teriparatide denosumab, or selective estrogen receptor modulator (SERMs) that can either slow bone loss or help to form new bone.
Like any medications, these medications have risks and not all of these medications are necessarily right for you. So be sure you and your doctor discuss the pros and cons of taking any medication and weigh their risks with the serious risk of not treating osteoporosis.
To learn more about osteoporosis and dexa scans, click here.
Rebecca M. Shepherd, M. D., specializes in the treatment of osteoarthritis, osteoporosis, rheumatoid arthritis, and autoimmune disease. She is a graduate of the University of Texas and Vanderbilt University’s medical school and served her residency and fellowship at Washington University.