Today measuring bone mass density is standard medical procedure in the diagnosis of osteoporosis. However, these tests have only been around for approximately 25 years. In the early years, osteoporosis was a disease that was only detected after an individual suffered from a low impact or low trauma fracture. By this time the bones had already been weakened and the individual was destined to a lifetime of frailty.
In the early 1970s researchers were able to measure bone mass at the wrist only and by the mid-1980s could obtain hip and spine measurements. However, due to be radioactive source required for the test it was housed in the nuclear medicine department of hospitals.
By 1989 the current DEXA became available and replaced the need for nuclear medicine. However, since the only treatment available at the time was estrogen replacement therapy or calcitonin injections, physicians were not enthusiastic about sending patients to have their bone scan for a disease that for the most part, was being treated when women were being treated for their menopausal symptoms.
This all changed with the approval by the Federal drug administration for several different types of medications which would help the body to lay down more bone. In 1995 the food and drug administration approved a new type of DEXA machine which measures bone mass in the forearm. This is called a peripheral DEXA. The general consensus was that it could be useful for first-time screenings to rule out osteoporosis in patients whose bone density fall within one standard deviation of normal. However, individuals whose measurements lie between one and 2.5 standard deviations require the DEXA of their hip or spine because bone loss changes are not the same over the entire body. In other words, the wrist may have lost bone or gained bone while the spine and hip may or may not have improved.
A bone density test is a fairly accurate predictor of the risk an individual faces of a low impact fracture. The results will let the physician know how you compare against other individuals of your same age, sex and other similar characteristics. Doctors will use this bone density tests to determine if an individual either has or is at risk of developing osteoporosis.
The bone density test is not the same as having a bone scan done. Bone scans require an injection of some type of radioactive material which is absorbed by the bones and usually used to detect certain types of fractures, cancer, infections and other abnormalities. Bone density scans are recommended for every woman over the age of 65 or for those individuals who are 60 and at increased risk of developing osteoporosis.
The older an individual gets, the higher their risk of developing the disease because the bones become weaker as you age. Risk factors for osteoporosis include age, race, weight, a personal history of fractures, a family history of osteoporosis, past nutritional history and current medical history. There are certain medications and diseases which can increase normal bone loss.
Not all health insurance plans will cover a bone density test, so be sure to prior authorize it with your insurance provider prior to the test. While it can confirm if your bone density is low or high, it cannot tell you why this is occurring. Women over the age of 65 and postmenopausal, are at higher risk for developing osteoporosis. But, to answer the question of why osteoporosis has developed the physician must do a complete medical evaluation, including history and physical. In this way they will look for other underlying medical reasons which may place the individual at higher risk for osteoporosis.
These tests are very fast and painless. There is no preparation needed from the individual aside from making an appointment and showing up. If the bone test is done in a medical center be sure to inform the evaluator if you have recently had any oral contrast or nuclear medications testing. Because these tests require radioactive tracers they can interfere with the results of a bone density test, making your time and efforts completely useless.
In the dual energy x-ray absorptiometry (DEXA) scan will be done at either the hip or spine because these areas are at higher risk and are the preferred site for diagnosing osteoporosis. Exposure to radiation during a bone density tests is approximately 1/10 of the amount received during a normal chest x-ray. The tests will take between five and 10 minutes to complete.
Peripheral devices that are found in pharmacies are less expensive but have their limitations. However, the physician may wish to have a bone density done of the heel or finger or even forearm in order to screen for osteoporosis and recommend a central scan of the hip or spine if the peripheral test is positive.