The only sure way to determine bone density and fracture risk for osteoporosis is to have a bone mass measurement (also called bone mineral density, BMD test or DEXA). This procedure is done quickly and painlessly here in the office. Dr. Strobel is certified to interpret bone density scans and is a member of the International Society for Clinical Densitometry or ISCD.
Here are some guidelines to help you determine whether you should have a BMD test. BMD testing should be performed on:
All women aged 65 and older regardless of risk factors
Younger, postmenopausal women with one or more risk factors (other than being white, postmenopausal and female).
Postmenopausal women who present with fractures (to confirm the diagnosis and determine disease severity).
Note: Medicare should cover BMD testing for the following individuals aged 65 and older:
Estrogen deficient women at clinical risk for osteoporosis individuals with vertebral abnormalities
Individuals receiving, or planning to receive, long-term glucocorticoid (steroid) therapy
Individuals with primary hyperparathyroidism
Individuals being monitored to assess the response or efficacy of an approved osteoporosis drug therapy.
Medicare permits individuals to repeat BMD testing every two years routinely or more often if there is osteoporosis.
There are several ways to measure bone mineral density; all are painless, noninvasive and safe and are becoming more readily available. In many testing centers you don't even have to change into an examination robe. The tests measure bone density in your spine, hip and/or wrist, the most common sites of fractures due to osteoporosis.
Your bone density is compared to two standards, or norms, known as age matched and young normal. The age-matched reading compares your bone density to what is expected in someone of your age, sex and size. This is called a Z-score. The young normal reading compares your density to the optimal peak bone density of a healthy young adult of the same sex. This is the T-score and is usually used to determine whether or not someone should receive medical therapy or medications to treat abnormal bone density.
The information from a bone density test enables your doctor to identify where you stand within ranges of normal and to determine whether you are at risk for fracture. One more piece of information is called a FRAX score and allows the practitioner to know if the patient is considered low-risk or high-risk for an osteoporotic fracture. In general, the lower your bone density the higher your risk for fracture. Test results will help you and your doctor decide the best course of action for your bone health.