Bone-Density Test

Osteoporosis is responsible for 1.5 million bone fractures every year. The disease can progress slowly, without your knowledge -- unless you get tested for it. More than 50% of women age 50 and older will end up with brittle bones or full-blown osteoporosis. About 15% of men over 60 are diagnosed with osteoporosis, and many more cases go undiagnosed. Without early and regular testing, the disease may be discovered only after much of the damage is done -- when a sudden strain, bump, or fall results in a fracture, or when a "dowager's hump," caused by compression fractures of the spine, has already formed.

Who needs it All women over age 65 should be screened. After an initial test and/or diagnosis of osteoporosis, your doctor may recommend annual tests to monitor its progression and your response to treatment. Women and men 55 or older who have at least one major risk factor for osteoporosis, such as low calcium intake or a broken bone after age 50, should also get tested.

How it's done Two tests commonly used to evaluate bone density are the dual energy X-ray absorptiometry (DEXA) and the ultrasound scan. The DEXA is the most accurate test and is used mainly for diagnosis and for assessing treatment, but it may also be used for screening. (Insurance coverage varies, depending on your age and risk factors; check your policy.) The test, which emits low levels of radiation, measures bone density at the spine, hip, and/or wrist -- considered to be the most reliable areas for measurement. The ultrasound scan, on the other hand, is used only for screening. It emits no radiation, is much less expensive than the DEXA, and measures bone density in the wrist or heel.

What the results mean If an ultrasound shows osteoporosis, the doctor will usually order a DEXA. DEXA scores compare your bone mass to the standard. A score of -1 to -2.5 indicates osteopenia (decreased bone density). A score of -2.5 or lower means you have osteoporosis. Any scores higher than -1 indicate healthy bone mass.

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