The Importance of Bone Density Testing in Preventing Osteoporosis

To support the weight of a human body, bones must be very strong. Bones get their strength from densely packed cells and tissues. While it may seem like bones are static and unchanging, bone tissue is quite alive and ever-changing. Bone cells are constantly at work to replace old bits of bone with new, healthier tissue. This process and calcium and other minerals keep our bones dense and strong.

As we age, though, we can lose more bone than we create, leading to porous and brittle bones. Left untreated, the loss of bone density can weaken bones and increase the risk of bone fractures; doctors refer to this state as osteoporosis.

Bone Density Testing

Osteoporosis does not usually cause any symptoms, so most people with weakened bones don’t realize they have the condition until they experience a bone fracture. Bone density tests help people avoid fractures by alerting them to problems with their bones early before they suffer a fracture.

What is a Bone Density Test?

Bone density testing measures bone strength. Healthcare providers use bone density testing to assess the bone health of their patients.

Who Should Get A Bone Density Test?

The U.S. Preventive Services Task Force (USPSTF) recommends screening for osteoporosis to prevent bone fractures in:

• Women who are aged 65 or older
• Women who are younger than 65 and have an increased risk

While USPSTF does not offer guidelines for routine testing in men, some men can benefit from bone density testing if they have certain health conditions or take medications that raise their risk.

High-Risk Individuals

Some people are at higher risk for developing osteoporosis than others. Risk factors for osteoporosis include:

• Smoking cigarettes
• Using prednisone or other steroid medications for a long time
• Low body weight, typically less than 127 lbs. (58 kg)
• Rheumatoid arthritis is an autoimmune disease that damages joints
• A personal or family history of a bone that fractured after very little trauma, such as falling from standing height or less, or no trauma at all
• Drinking three or more alcoholic beverages per day

Age Considerations

Osteoporosis is an age-related condition, which means people are more likely to develop this bone disease as they age.

More than 12 percent of adults aged 50 and over have osteoporosis of the hip, spine, or both.

Medical Conditions Affecting Bone Health

Some health issues may be associated with osteoporosis. These conditions include

• Diabetes
• Untreated hyperthyroidism, a condition characterized by an over-active thyroid gland
• Hyperparathyroidism, which is a condition marked by overactive parathyroid glands, located at the back of the thyroid gland in a person’s neck
• Early menopause
• Chronic malnutrition or malabsorption
• Chronic liver disease

Preparation for the Test

There are no special preparations for a bone density scan. Do notify the radiology staff if you are pregnant or think you are pregnant.

Dietary Considerations

It is okay to consume foods and beverages that contain calcium, such as milk and cheese, before the test.

What to Wear

Be sure to wear comfortable clothing. Avoid wearing any clothing with metal zippers, fasteners, clasps, or hooks in the area of the body being scanned. The technician may ask you to wear a hospital gown for the scan.

Medications to Avoid

Before undergoing a DEXA scan, do not take any calcium supplements or antacids, as they may contain calcium.

Understanding the Test Procedure

To undergo a bone density scan, most patients lie on an examination table while the technologist performs the test, typically focusing on areas like the spine, hips, or forearm. If a patient is unable to lie flat, the test can also be performed while they sit, often targeting the arm.

How is a bone density test done?

An X-ray machine passes a small amount of radiation through the patient’s bones to create an image. A radiologist interprets the images and information gained during the scan to determine if the patient has osteoporosis.

Overview of The DEXA Scan

Dual-energy X-ray absorptiometry (DEXA) is the most common type of bone density testing. It uses two low-energy x-ray beams to create images of both bone and soft tissue.

Duration and Experience

Depending on the equipment used, the experience of the technicians, and the areas being scanned, a DEXA scan typically takes 10 to 30 minutes.

Safety and Comfort

A bone density test procedure is safe, painless, and comfortable. While it does use radiation to create images of bones, the amount of radiation you are exposed to in a DEXA scan is less than the environmental radiation you would receive throughout a normal day.

Interpreting Bone Density Test Results

The radiologist will interpret the images and assign a score that describes the condition of your bones. There are two types of scores: T-scores and Z-scores. The doctor who ordered the test will tell you what your score means.

T-Scores and What They Mean

T-scores compare the condition of your bones with the healthy bones of a young person. Medical professionals often consider the T-scores to be more important.

T-scores may be a positive (+) or a negative (-) number, with lower scores indicating lower bone density. In other words, the higher the T-score, the better.

People with normal bone density usually have a T-score of -1 to +1 and do not require treatment. Those with osteoporosis have a T-score of -2.5 or less.

Z-Scores Explained

Z-scores compare the condition of your bones with those of a healthy person who is the same age as you; they take body mass index (BMI) and gender into account, and return scores that are positive or negative. Scores of -1.5 and above indicate the typical bone density of someone of the patient’s BMI and gender, whereas scores lower than -1.5 may indicate weakened bones.

Diagnosing Osteoporosis and Other Conditions

Diagnosing osteoporosis and other conditions, such as osteopenia, relies heavily on bone density scans. To reach a diagnosis, a doctor will also consider the patient’s gender, age, weight, diet and exercise habits, health conditions, and medications.

Treatment Options for Low Bone Density

Treatment for low bone density usually focuses on slowing bone loss.

Lifestyle Changes

Lifestyle changes include eating a diet rich in calcium and vitamin D, quitting smoking, limiting alcohol, and getting regular exercise.

Medications

Medications containing bisphosphonates are typically the first choice for treating osteoporosis. Bisphosphonates include:

• Alendronate (Fosamax), a pill taken weekly
• Risedronate (Actonel, Atelvia), a pill taken weekly or monthly
• Ibandronate, a pill taken monthly, or quarterly intravenous (IV) infusion
• Zoledronic acid (Reclast), a yearly IV infusion

Denosumab, a twice-yearly IV injection, is for people who cannot take bisphosphonates.

Supplements

Calcium supplements help people who cannot get enough calcium through their regular diet.

Follow-Up Testing and Monitoring

Patients who have a T-score of -2.00 to -2.49 or who take medications that reduce bone density may benefit from follow-up scans every two years, and those with a T-score of -1.50 to -1.99 may benefit from repeat testing every three to five years. Doctors may recommend that those with a T-score of -1.01 to -1.49 repeat testing every 10 to 15 years.

Proactive Bone Health Management

Bones are living tissues that constantly regenerate, but as we age, bone loss can outpace bone creation, leading to osteoporosis. Here’s how to proactively manage your bone health.

Tips For Maintaining Healthy Bones

• Prioritize Calcium & Vitamin D: These two nutrients are essential for bone strength. Make sure you’re getting enough from your diet or supplements if needed.
• Stay Active: Regular weight-bearing exercises, like walking or resistance training, help build and maintain bone density.
• Avoid Smoking & Excess Alcohol: Both habits weaken bones over time, so reducing or eliminating them is key for bone health.

Role Of Nutrition And Exercise

Nutrition and exercise are the foundation of good bone health. A balanced diet rich in calcium—found in dairy products, leafy greens, and fortified foods—supports bone strength. Equally important is getting enough vitamin D through sunlight, fatty fish, or fortified foods to ensure calcium is absorbed properly. Exercise plays a crucial role, too. Weight-bearing activities like hiking, running, and resistance training stimulate bone growth, keeping them strong and reducing the risk of fractures.

Importance Of Regular Check-Ups

Regular check-ups are essential for monitoring bone health, especially as we age. By staying proactive with routine screenings and follow-up tests, you and your healthcare provider can address any changes in bone density and take preventive measures to maintain bone strength for years to come.

For more information on the importance of bone density testing to prevent osteoporosis, consult with your doctor. You can also learn more by contacting NVRA.