Bone densitometry

Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today's established standard for measuring bone mineral density (BMD).

An x-ray (radiograph) is a non-invasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays 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.

DXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DXA scanning.

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bone density scan

What are some common uses of the procedure?

DXA 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, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.

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

The DXA test can also assess an individual's risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.

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 a parathyroid condition, such as hyperparathyroidism
  • Have experienced a fracture after only mild trauma.
  • Have had x-ray evidence of vertebral fracture or other signs of osteoporosis.

The Lateral Vertebral Assessment (LVA), a low-dose x-ray examination of the spine to screen for vertebral fractures that is performed on the DXA machine, may be recommended for older patients, especially if:

  • They have lost more than an inch of height
  • Have unexplained back pain
  • If a DXA scan gives borderline readings