The Bone Density test comes in many forms. You may have seen
small machines at Health Fairs or at your local pharmacy.These devices measure bone density by ultrasound technology. It is inexpensive, portable and there is no radiation exposure. Several studies have shown it to be a good predictor of fracture risk. It is sometimes called Quantitative Ultrasound(QUS).
However, ultrasound is not recommended to monitor osteoporosis long term because of limited precision of
machine and
fact that bone mass at peripheral sites (e.g. heel) changes very slowly. If an ultrasound test reveals an abnormal result we suggest obtaining a confirmatory DXA scan of
hip and spine.
It is also possible to use Quantitative Computed Tomography (QCT) to measure bone density. It is used less often than DXA. It is more expensive, less reproducible and emits a higher radiation dose than DXA.
So let's talk a little about DXA. DXA is short for Dual X-Ray Absorptiometry. It is also known as DEXA, Bone Densitometry or
Bone Mineral Density (BMD) test/scan. It is really
'gold standard' of bone density measurement techniques. DXA uses a very low radiation dose. The radiation is equivalent to
dose received when flying on an airplane from San Francisco to New York! So as you can see
exposure is minimal, but you should NOT undergo a scan if there is any chance of you being pregnant. DXA measures
BMD in one hip and in
lumbar spine. A few centers will measure both hips. Smaller, more mobile peripheral DXA devices are also used(pDXA). Talk to your physician about which Bone Density Test is available in your area.
So when you have had your scan you will be given a t-score. This is a statistical number that compares your bone density to that of a young adult. The more negative
t-score
worse your bone density. The lower
t-score
higher your risk of fracture. Take a look at this scale to see where your t-score lies.
The World Health Organisation classifies your t-score as follows:
T-SCORE better than -1.0 is NORMAL
T-SCORE from -1.0 to -2.5 is OSTEOPENIA
T-SCORE -2.5 or worse is OSTEOPOROSIS
On
day of
exam, eat normally, but don't take calcium supplements for at least 24 hours beforehand. Wear loose, comfortable clothing, avoiding garments that have zippers, belts, or buttons made of metal. Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan; you may have to wait 10-14 days before undergoing a DEXA test. Women should always inform their physician or x-ray technologist if there is a possibility they are pregnant.