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Diagnosing Osteoporosis

Bone Mineral Density testing

There are two ways to find out you have osteoporosis: breaking a bone and getting a bone density test. Breaking a bone is painful, expensive and debilitating. Getting a bone density test is not. We hope that the information on this website will help you prevent fractures and bone loss. It is never too late to help your bones be healthier.

Just as it is important to know your blood pressure or height, it is important to know your T-Score, which is your bone density test result. For most women, the time to watch your T-Score is shortly after menopause when declining estrogen levels no longer protect your bone density. While not universally agreed upon, there are also other cases when a bone density test may be appropriate. At FORE, we also consider older men, people who have taken medications that affect bone density for prolonged periods (such as some asthma and steroid medications), and people with a history of osteoporosis or fractures in their family. Knowing your T-Score and risk factors help you and your physician decide how aggressively you should address osteoporosis prevention and treatment.

What’s the difference between central and peripheral bone
density tests?

pDXA vs. DXA:
All forms of bone density testing are accurate and useful. But different tests will answer different questions for you and your doctor.

Some test methods are used for scans of the central skeleton (your hip and spine):

• DXA (dual energy x-ray absorptiometry)
• CT (computerized tomography)

Other methods are used to scan "peripheral" parts of your skeleton- those parts that are further away from your spine:

• DXA of your wrist, heel, finger or hand
• SXA (single energy x-ray absorptiometry) of your heel
• Ultrasound of your heel
• CT scan of your wrist

Which test your doctor will suggest depends on what she/he is looking for and why. If you are approaching menopause and considering hormone replacement therapy (HRT), for example, your doctor may want to know the bone density of your hip and spine to help you decide about HRT. (HRT can help reduce bone loss related to the loss of estrogen at menopause.) If you are already taking HRT, Fosamax, or some combination of drugs, your doctor may want to monitor your progress. That's done best by testing your spine because it may take a long time for changes (good or bad) to show in your heel, wrist or fingers. They type of bone in your spine responds more quickly to treatment medications.

On the other hand, if you have no known risks of osteoporosis such as a family history, past fractures or use of steroids for a long time, you might consider a scan of your wrist, heel or other peripheral body part. There is an 85% "correlation" rate between test results of your hip, spine and other sites. In other words, the bone density in one part of your skeleton will look very much like the density in your other bones if you are like most people. The older you are, the more this relationship holds true. The lower your bone density, the more likely you are to have a bone break because of osteoporosis. We know that hip fractures can be fatal, and spine fractures can be painful and disfiguring. Knowing your bone density can help you prevent those problems now.