Who Needs a Bone Density Test (aka: DEXA Scan) and How Often?

Bone density tests are one of the only ways we have to look inside your bones to determine how healthy and strong they are. This simple test lets you know whether you have osteopenia (i.e., less than optimal bone mass), osteoporosis (i.e., actual bone mass loss) or normal, healthy bones.

Across the world, women and men over age 50 suffer 37 million fragility fractures due to weakened bones. That’s about 70 fractures every single minute.

Unfortunately, many risk factors for osteoporosis are beyond your control. Even when you eat a healthy, whole foods diet and exercise regularly, you may be at increased risk for osteoporosis and fractures if you are:

• Aging
• A postmenopausal woman
• Low in estrogen (women)
• Low in testosterone (men)
• Current or past steroid user
• Caucasian or Asian
• Small-boned
• Thin
• From a family with a history of osteoporosis
• Suffering from an eating disorder

Even if you don’t fall into higher-risk-factor categories for osteoporosis, that doesn’t mean you’re immune to the disease. Any adult over age 40 is at increased risk. Just as your skin and muscles lose tone and strength as you age, so do your bones.

That’s why Joseph Calandra, MD, and Karen Mass, MD, at Mass Medical Imaging encourage you to get regular bone density tests, otherwise known as dual-energy x-ray absorptiometry (DEXA) scans. Our expert doctors help you understand your individual risk for osteoporosis, devise a customized schedule, and interpret your bone density scans at our office in Lake Forest, Illinois.

Do you need a DEXA scan, and how often do you need one? Find out below.

When to get your first DEXA

The recommended timeframe to get your first DEXA varies highly by individual. General guidelines from the Radiological Society of North American strongly advise a DEXA if you:

• Are a postmenopausal woman and you don’t take estrogen
• Have a personal or maternal history of hip fracture
• Smoke
• Are a tall (over 5’7”) post-menopausal woman
• Are a thin (less than 125 pounds) postmenopausal woman
• Are a man with rheumatoid arthritis, chronic kidney or liver disease
• Use corticosteroids, anti-seizure medications,certain barbiturates, or high-dose thyroid replacement drugs
• Have type 1 diabetes, liver disease, or kidney disease
• Have a family history of osteoporosis
• Have high bone turnover, as evidenced by excess collagen in urine samples 
• Have hyperthyroidism or hyperparathyroidism
• experienced a fracture after only mild trauma
• Had x-ray evidence of vertebral fracture
• Have lost more than one inch of height

In general, we recommend that you have your first DEXA scan by age 50 at the latest. That way, even if your bones are still healthy, you have a good baseline by which to measure your subsequent scans.

When to get your next DEXA

Unless you’ve suffered a recent fracture, you usually don’t need another DEXA scan right away. The general guidelines for follow-up DEXAs are based on your DEXA results and are:

• Every other year for high risk
• Every 3-5 years for moderate risk
• Every 5-10 years for low risk

Your first DEXA scan results let your doctor know what category you fall into. DEXA results include a T-score (compares your bones to healthy, young bones)  and a Z-score (compares your bones to other people of your age, sex, and ethnic background).

T-score

• Normal (i.e., low risk): -1 and above https://www.bones.nih.gov/health-info/bone/bone-health/bone-mass-
• Osteopenia (i.e., moderate risk): between -1 and -2.5 I 
• Osteoporosis (i.e., high risk): T-score of -2.5 and below   

If you have osteopenia or osteoporosis, we may recommend medications to help retain bone mass as well as supplements, dietary changes, and an exercise regimen.

Z-score

Z-scores are based on your sex, age, and ethnic group. If your Z-score is abnormally low compared to other, similar people, we may order more tests to determine if you have a medical condition that’s affecting your bone density.

Book your first or next bone density scan in Lake Forest, Illinois, by calling our friendly team or using our online appointment form today.