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    What is a Bone Density Scan (DEXA)? 
 
Bone density scanning, also called dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DEXA is today's established standard for measuring bone mineral density (BMD). DEXA stands for "dual-energy x-ray absorptiometry," and is considered the most accurate test for bone density. While standard x-rays show changes in bone density after about 40% of bone loss, a DEXA scan can detect changes after about a 1% change. A DEXA scan lasts about 10 minutes, and exposes the patient to less radiation than a standard chest x-ray (about the same amount of radiation exposure as taking a trans-continental flight).

An x-ray (radiograph) is a painless medical test that helps physicians diagnose and treat medical conditions. Radiography involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

DEXA is most often performed on the lower spine and hips.

DEXA bone densitometry is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men. Osteoporosis involves a gradual loss of calcium, causing the bones to become thinner, more fragile and more likely to break.

DEXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.

The DEXA test can also assess an individual’s risk for developing fractures.

Bone density testing is strongly recommended if you:

  • are a post-menopausal woman and not taking estrogen.
  • have a personal or maternal history of hip fracture or smoking.
  • are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
  • are a man with clinical conditions associated with bone loss.
  • use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
  • have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
  • have high bone turnover, which shows up in the form of excessive collagen in urine samples.
  • have a thyroid condition, such as hyperthyroidism.
  • have experienced a fracture after only mild trauma.
  • have had x-ray evidence of vertebral fracture or other signs of osteoporosis.
How does the procedure work?
The DEXA machine sends a thin, invisible beam of low-dose x-rays with two distinct energy peaks through the bones being examined. One peak is absorbed mainly by soft tissue and the other by bone. The soft tissue amount can be subtracted from the total and what remains is a patient's bone mineral density.

DEXA machines feature special software that compute and display the bone density measurements on a computer monitor.

Benefits
  • DEXA bone densitometry is a simple, quick and non-invasive procedure.
  • No anesthesia is required.
  • The amount of radiation used is extremely small—less than one-tenth the dose of a standard chest x-ray.
  • DEXA bone density testing is the most accurate method available for the diagnosis of osteoporosis and is also considered an accurate estimator of fracture risk.
  • DEXA equipment is widely available making DEXA bone densitometry testing convenient for patients and physicians alike.
  • No radiation remains in a patient's body after an x-ray examination.
  • X-rays usually have no side effects.
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 or BMD test).

Your doctor can help you determine whether you should have a BMD test. NOF Guidelines indicate, 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 covers 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.

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. Recently, bone density tests have been approved by the FDA that measure bone density in the middle finger and the heel or shinbone. 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. The young normal reading compares your density to the optimal peak bone density of a healthy young adult of the same sex.

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. 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.

 
 
 
 
     
 
 
 
 
 
 
 
 
 
 
 
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