4 October 2023
Osteoporosis is a degeneration of bone tissue that makes it more fragile and more likely to break. A bone density test measures the amount of calcium and other minerals that are in segments of your bone to determine how strong the bone is and, therefore, the potential damage. It can also detect existing fractures, infections, or other abnormalities. The x-ray will look at spine and hips and sometimes the forearm. This test is used to determine how much, if any, bone tissue is lost and risk of a future break. It will confirm a diagnosis or osteopenia or osteoporosis and help guide treatment options.
The higher the mineral content in your skeletal system, less likely you are to experience a fracture. Osteoporosis is more common in older women (remember “dowager humps”?) but it can occur in both genders and at various ages. Some indicators can be:
- Lost height of at least 1 ½ inches indicating a compression in the spinal area.
- Fractures, especially those caused by minor mishaps or even a sneeze.
- Long term use of steroids.
- Hormone level drops including menopause, some cancer treatments, or other issues.
Other contributing factors can include:
- A close relative (particularly a mother or grandmother) who had osteoporosis or was prone to bone fractures.
- Medications like corticosteroids for rheumatoid arthritis or anti-seizure medications.
- Low body weight or slight build.
- History of tobacco use or heavy drinking.
The tests are fast and painless. Basically you will lay on a bed and a machine will whir over your body and produce a visual image for interpretation. It will probably take less than 30 minutes to finish the exam. If you are at a health fair or other such event, they often measure fingers, wrists or heels. These are done using a small, portable peripheral device. A more accurate measurement is the one described early in this paragraph because the thickness or density of the bone can vary from one location in your body versus another area.
Notify your doctor if you have had a recent barium exam or contrast material for a CT or nuclear medicine procedure. No calcium supplements within the previous 24 hours, but milk and cheese are perfectly fine.
Wear loose, comfortable clothing. If you are wearing something with a zipper, belt, or buttons, you will probably be asked to don one of those “lovely” hospital gowns. Empty pockets of keys, change, or other metal objects. No jewelry.
The results are reported in a T-score and Z-score. The T-score is how you fair compared to a health, young adult of your same gender. It shows whether you are above or below what the norm should be in that other person. A Z-score measures against a normal reading in someone of your age, gender, weight, and ethnic or racial origin. Looking at these numbers will help your medical team decide if additional tests are warranted and whether or not to consider medications.
Most healthy, young people will not necessarily be a candidate for a bone density test. Because men without fractures generally have a higher bone mass and slower bone loss than women, they are less likely to experience a bone break. Testing is recommended for men 70 or older. Men aged between 50 and 69 and women under 65 may consider the test if they have risk factors mentioned earlier in this article. Anyone over 50 who has broken a bone or lost at least 1 ½ inches of height, should speak with their primary care team.