Dual Energy X-ray Absorptiometry (DXA)
What is osteoporosis?
Osteoporosis literally means "porous bone." As we age, our bones naturally lose thickness and strength. Osteoporosis leads to an increased risk of fractures (breaks). Called the "silent crippler," osteoporosis often develops without symptoms or pain until a fracture occurs.
After age 50, one in two white women and one in four white men will have an osteoporosis-related fracture in their lifetimes. An additional 30 percent have low bone density that puts them at risk of developing osteoporosis (including African- Americans). Osteoporosis is responsible for more than 2 million fractures each year, and this number continues to grow.
Hip fractures are a serious health threat of osteoporosis. After menopause, the risk of osteoporosis is increased in the vertebral body of the spine, wrist, and hip. Hip fractures often cause a loss of independence and the need for nursing home care. Medical problems after hip fractures can be life-threatening.
The best way to avoid osteoporosis is to determine your risk and then take steps to prevent the disease. It is important to start early. With proper diet and exercise, you might be able to slow or prevent the start of osteoporosis. If you already have the disease, early detection and proper medical care can help slow or even reverse its progress.
Are you at risk for osteoporosis?
Bone loss in women begins at about age 30 and speeds up after menopause. Women over the age of 50 have the greatest risk for developing osteoporosis. It is important to remember that the disease is not limited to women. One in eight men over the age of 50 is at risk for developing osteoporosis. Other risk factors include:
Family history (others in your family) of osteoporosis
Being thin or "small-boned"
Caucasian or Asian race (although African-Americans and Hispanic-Americans are at risk, as well)
Early menopause (before age 45) or surgically induced menopause (caused by surgery)
Amenorrhea (no regular menstrual periods) in pre-menopausal women
A diet low in calcium or vitamin D
Low testosterone levels in men
Using too much alcohol
Having certain diseases, such as asthma, lung disease, intestinal problems, kidney problems, hormonal problems, liver disease, primary hyperparathyroidism, rheumatoid arthritis, diabetes, anorexia nervosa, or bulimia
Being an organ transplant recipient
Use of certain medicines such as corticosteroids and anticonvulsants (seizure medicines)
What can you do to prevent osteoporosis?
Eat a balanced diet rich in calcium and Vitamin D.
Maintain a healthy lifestyle.
Prevent falls (for example, by removing loose wires, cords, and rugs around your house; wearing sturdy rubber-soled shoes; installing grab bars in your tub or shower) so you can stay active.
Who should get tested for osteoporosis?
An initial examination for osteoporosis is recommended when you reach menopause if you have risk factors. This evaluation will let you know about any problems, and will allow doctors to prescribe treatments to limit bone loss and watch your progress as you grow older. All women over the age of 65, and men with risk factors, should have a bone density test.
Dual energy X-ray absorptiometry (DXA)
The most accurate test for detecting osteoporosis and other bone diseases is dual-energy X-ray absorptiometry (DXA). This test, which takes about 10 to 15 minutes, measures the bone loss in your hips and spine. It also helps your doctor determine how quickly you are losing bone density and predict your risk of fracture. The test is also used to follow the course of the disease and observe the effects of various treatments.
Before your DXA test. You do not have to change your daily routine before this test. Eat, drink, and take your medicines as you normally would. However, do not take calcium supplements (such as Tums) for 24 hours before your bone densitometry test. If you think you might be pregnant, tell your doctor. Also, do not take multivitamins that contain calcium for 24 hours before the test.
During the test. You must wear a hospital gown. You will be asked to lie on your back while the technologist performs the test. There are no needles or injections in this test. The DXA procedure is similar to having a standard X-ray. The amount of radiation used is very small.
After the test. Generally, you can resume your usual activities immediately. The results of your test will be reviewed by a specially trained technologist and certified doctors. Your test results will be provided to your doctor, who will discuss the results with you.
Other information. Retail stores sometimes sell a version of the DXA machine that measures bone mass in your forearm, or ultrasound of the heel. However, these readings do not reflect the bone loss in your hips and spine, where the most common debilitating (disabling) fractures occur. Medicare covers bone density testing for many patients, as required in the Bone Mass Measurement Act of 1998.
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