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Bone Density Test

Posted on June 15, 2018 | No Comments on Bone Density Test

Bones are one of the most neglected parts of the human body. We never realize how important our bones are until we grow old and experience different bone pains and injuries. According to the International Osteoporosis Foundation, “as we get older, we are no longer able to replace bone tissue as quickly as we lose it.”

Women are more prone to bone diseases than men. Their body framework and women’s declining ability to produce estrogen as they age are the reasons they are prone to such diseases. When this happens, the bones become less dense until it produces holes and becomes light and weak, causing osteoporosis. However, men shouldn’t be too complacent either for they also suffer from bone loss, although the rate of loss is much slower than in women.

To avoid getting complications of bone disorders, it is better to prevent bone diseases from developing in the first place. Aside from eating foods rich in calcium, drinking milk and doing regular exercise, having a bone health check regularly is imperative.The bone density test is a useful tool in detecting osteoporosis, bone and joint problems and the risk of fractures.

What is the Bone Density Test?
The Bone Density Test measures how many grams of calcium and other bone minerals, also known as bone mineral content,are packed into a segment of bone. The higher the bone mineral content, the denser the bones are. Dense bones mean healthy and strong bones. Apart from measuring the density of your bones, the test also detects osteoporosis before a fracture occurs, helps predict your chances of developing another fracture in the future, and monitors the effectiveness of treatments for osteoporosis.

There are two standards used to compare the bone density test “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. On the other hand, the young normal reading compares your bone density to the optimal peak bone density of a healthy young adult of the same sex.

Don’t confuse the bone density test with a bone scan. They seem similar, but the bone density test is far different from a bone scan. Bone scans require injection beforehand and are usually used to detect fractures, cancer, infections and other abnormalities in the bone.

Who Needs to Undergo the Bone Density Test?
The US Preventative Services Task Force recommends women aged 65 and older to undergo bone density test at least once a year. It is also recommended to have bone density test if you are 60 years old and have an increased risk for osteoporosis. Under the guidelines from the National Osteoporosis Foundation, all postmenopausal women under age 65 who have one or more additional risk factors*, women age 65 and older regardless of additional risk factors, postmenopausal women who have sustained a fracture, women who are considering therapy for osteoporosis if bone density testing would facilitate the decision, and women who have been on hormone/estrogen replacement therapy (HRT/ERT) for prolonged periods, should undergo a bone density test.

What to do Before theTest?
There are no necessary preparations needed before going into bone density testing. The bone density test is simple, fast and painless. In fact, there are simple versions of bone density tests which can be done in local pharmacies and clinics.
If you will have your bone test done in the hospital, be sure to tell your physician beforehand if you’ve had recent oral contrast or nuclear medicine tests.These tests require an injection of radioactive tracers that might interfere with your bone density test.

How is it done?
The test is usually done on bones that are most likely to break because of osteoporosis. These sites include the lumbar vertebrae, which are in the lower region of your spine, the narrow neck of your femur bone adjoining the hip, and the bones of your wrist and forearm.

There are two kinds of equipment used in a bone density test—the central device and the peripheral device. The central device includes large machines on which you can lie down while your bones are checked. The most common central devices for bone density test are DEXA scan and Quantitative CT scan.

DEXA scan or Dual Energy X-ray Absorptiometry scan measures the bone density at your hip or spine. This test provides very precise results and is the preferred testfor diagnosing osteoporosis. During the test,you ‘II be asked to lie down on a padded platform for a few minutes while an imager, a mechanical arm-like device, passes over your body. However, you will expose yourself to low radiation, the same radiation emitted during a chest X-ray.The DEXA test usually takes five to 10 minutes to complete.

Meanwhile, the Quantitative CT scan uses computerized tomography (CT) scanner combined with computer software to determine your bone density, usually at your spine. It provides detailed, three-dimensional images and can take into account the effects of aging and diseases other than osteoporosis on your bones. Same as DEXA, you are to lie down on a movable table that’s guided into a large tube-like area where images are taken.The difference is that the QCT scan emits more radiation than the DEXA.Also, it takes less than 10 minutes to complete the bone density exam using this device.

On the other hand, the peripheral device is a small, portable machine that measures bone density on the periphery of your skeleton, such as your finger, wrist, or heel. This device is mostly seen in pharmacies and is considered less expensive than central devices. These small devices have limitations.

A test performed on a peripheral location such as your heel, may predict risk of fracture in your spine and hip as well. However, since bone density tends to vary from one location to the other, a measurement taken at the heel isn’t as accurate as a measurement taken at the spine or hip.

What do the results mean?
There are two ways to report the results of the bone density test T-scores and Z-scores. The T-score compares the bone density to the optimal peak bone density for your gender. It is reported as number of standard deviations below the average. A T-score of greater than minus-1 is considered normal. AT-score of minus-1 to minus-2.5 is considered osteopenia and at risk for developing osteoporosis.A score of less than minus-2.5 is classified as osteoporosis.

Meanwhile, Z-score is used to compare the results of your bone density test to others of your same age, weight, ethnicity, and gender. This is useful to determine if there is something unusual contributing to your bone loss.A Z-score of less than minus 1.5 raises concern that factors other than aging contributed to the development of osteoporosis. These factors may include thyroid abnormalities, malnutrition, medication interactions, tobacco use, and others.

What are the pros and cons of the bone density test?
The bone density test is an essential tool in diagnosing osteoporosis and is fairly accurate in knowing your risk of fractures. In spite of the usefulness of this test, it also has its disadvantages. It may not accurately predict the risk of fracture because fracture risk would depend on other factors besides bone density. The test may also encourage patients to take unnecessary medications and it exposes them to low levels of radiation.

Although the bone density test will give you a general outlook on the health of your bones, you will still need thorough medical evaluation and doctor’s advice to know the true condition of your bones.

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