Bone Density Testing
Bone densitometry (BD) or central dual-energy x-ray absorptiometry (DEXA), has become an established and a well-known tool for diagnosing and following up patients with disorders affecting the bone mineralization such as osteoporosis or osteopenia. Osteoporosis has been defined as a condition characterized by low bone mass and deterioration of bone tissue, leading to enhanced bone fragility and increase in fracture risk. Osteopenia refers to decreased calcification or density of the bone. DEXA results are measured in units of grams per square centimeter (g/cm2 ) and are expressed as a "Z score" and a "T score". The value tested on an individual is compared to others' of the same age, sex, and race. This is called the Z-score. It is given in standard deviations (SD) from the average value for the specific age group. A negative (-) value indicates that an individual has thinner bones (lower bone density) than the average of people in their group. A positive (+) value indicates that one has higher bone density than the average of people in the group. In BD, the T-score is expressed as a standard deviation (SD), which is a statistical measure of how closely each person in a group is to the
DEXA uses two different X-ray beams. The average BD is determined by measuring the bone density of a large group of healthy 30-year-olds (young adult reference range). Once again a negative value indicates that one has thinner bones (lower bone density) than an average 30-year-old and a positive value indicates that he/she has higher bone density than an average 30-year-old. In general, these medications work by helping to strengthen the bones and prevent further bone loss. It should be noted that a fetus is more susceptible that an adult to radiation damage, therefore individuals who are pregnant should be thoroughly reviewed and assessed before any testing should occur. Portable machines (P-DEXA) can measure bone density in the wrist or forearm therefore for these measurements, one may be able to sit in a chair during the test. The densitometry machine will scan the bones and measure the amount of radiation they absorb. Procedure BD measurements can be done on several bones in the body. Also those with a personal history of fragility fracture after the age of 40 might require screening as well. Therefore it is strongly recommended that whenever possible, follow-up measurements for a given patient be obtained by the same technologist using the same scanning procedure and the same instrument as for the original measurement. The DEXA technique, which scans the hip and lower spine, takes only about 10 minutes to perform. One may need to lie with their legs straight or with your lower legs resting on a platform built into the table. For example, Bone Densitometry 6the radiation dose from DEXA is 1/1000th the dose received when a person flies from coast to coast and 1/2000th that received from chest radiography. Some of the most common medications include estrogen replacement therapy, Fosamax and Calcitonin.
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