The Importance of Bone Mineral Density Exams (DXA scans)

The Importance of Bone Mineral Density Exams (DXA scans)

A dual-energy absorptiometry (DXA) scan can provide a snapshot of your bone health. This test determines bone mineral density (BMD) and helps in establishing fracture risk, and, with serial testing, is a way to measure response to osteoporosis treatment. The most widely recognized test for determining BMD is the central DXA scan. It is painless - similar to having an x-ray but much less radiation. The scan measures bone density at  your hip and spine. (Often, a scan of the forearm will also be performed during central DXA testing.) Peripheral bone density testing measures density at the wrist, finger, or heel and are typically used for screening purposes only. DXA scans measure your bone mineral density and compares it to that of an established norm or standard to give you a score. Although no bone density test is 100-percent accurate, the central DXA can be an important predictor of whether a person will have a fracture in the future. Most commonly, DXA results are compared to the ideal or peak bone mineral density of a healthy young adult, and given a T score. A score of 0 means your BMD is equal to the norm for a healthy young adult. Differences between your BMD and that of a healthy young adult norm are measured in units called standard deviations (SDs). The more  standard deviations below 0, indicated as negative numbers, the lower your BMD and the higher your risk of fracture.

The National Osteoporosis Foundation (NOF) and the U.S. Preventative Services Task Force (USPSTF) recommended osteoporosis screening with DXA for women 65 years and older, and for men over 70. Earlier screening is recommended for both groups if risk factors are present. (Risk factors are such things as family history of osteoporosis, weight under 127 pounds, history of smoking or excessive alcohol consumption, poor diet, etc.) A recent review published in the Journal of General Internal Medicine determined that too few women are getting bone density scans. Researchers examined the medical records of 51,000 women aged 40 to 85 living in California and determined that only 57.8% of women aged 65 - 74 and 42.7% of women over age 75 received DXA screenings. Even with women age 60 to 64 with at least one risk factor, only 58.8% had a DXA. The researchers concluded that DXA screening is being underutilized.