By Susan Brady | 02/25/2016

What You Need to Know About Osteoporosis Screening

What You Need to Know About Osteoporosis Screening

Osteoporosis is a disease that causes bones to become abnormally thin, weakened and easily fractured. Currently in the United States, 54 million people have osteoporosis (about one in two women and one in four men over the age of 50). Because osteoporosis is so common in older adults, osteoporosis screening is extremely important.

Why Should You be Screened for Osteoporosis?

According to the National Osteoporosis Foundation (NOF), osteoporosis in the United States contributes to more than 2 million broken bones every year, including nearly 300,000 hip fractures. Fractures in older individuals can lead to premature mortality, loss of function and independence, reduced quality of life, and high medical costs.

There are rarely any symptoms with osteoporosis, and for that reason, it is often called “the silent disease.” For many, the first symptom is a broken bone. Despite its increasing prevalence in our society, osteoporosis is under-detected in the United States and screenings for osteoporosis are not routinely given to everyone.

How is Osteoporosis Diagnosed?

Because osteoporosis causes excessive bone breakdown, the best method of osteoporosis screening to determine the density of your bones is to have a bone mineral density (BMD) test done. Two leading DMB tests include DXA scans and quantitative ultrasounds.

DXA Scan

The DXA (dual energy x-ray absorptiometry) scan is the most common scan used to evaluate BMD and diagnose osteoporosis. The results of this scan give you two scores:

The T score compares your bone density with that of healthy young women or men.

The Z score compares your bone density with that of other people of your age, gender, and race.

With either score, a negative number means you have thinner bones than the average person, and the more negative the number, the higher your risk of a bone fracture. The DXA scan is the gold standard for the detection of low bone mass and can be a useful way to measure bone density over multiple years.

However, the DXA scan has also been shown to be imprecise. The results can vary depending upon the anatomical site tested, the machine used, the positioning of your body and the interpretation of the data. Therefore, when getting follow up DXA scans, it is important to go to the same facility, at roughly the same time of the year, and have the same part of your body scanned as you did in the previous tests.

Quantitative Ultrasound

Quantitative ultrasound (QUS) has emerged as a convenient and popular screening tool for osteoporosis. QUS uses high frequency sound waves to estimate the quality and mass of bone. Studies over the past decade show that QUS and DXA scans show similar results for bone mineral density.

The QUS also provides additional information on bone microarchitecture as well. The QUS is emerging as an alternative tool for determining BMD because it is a quick, cheap and non-radiating way to for assess bone quality. Unfortunately, most insurance companies will not reimburse for this test.

When Should You Get Screened?

The current guidelines for when an individual should get bone density testing apply if you are:

A woman age 65 or older or a man age 70 or older

A postmenopausal woman under age 65 or a man age 50 to 70 with one or more risk factors for osteoporosis

A woman who is in menopausal transition who has specific risk factors that increase fracture risk (such as low body weight or a prior fracture)

A woman or man over age 50 who has fractured a bone

A woman or man who has taken glucocorticoids for at least two months

A woman or man with a medical condition or taking a medication that places him or her at high risk for osteoporotic fractures

Advancing age and a drop in estrogen in women at the time of menopause and a drop in testosterone in men are the leading causes of bone loss and increased risk of osteoporotic fractures.

If women and men are not routinely screened until the ages of 65 and 70 years of age, respectively, early changes in bone density are missed. Early detection of any disease gives people a better chance of halting progression or even reversing disease, and osteoporosis is no different. Early detection, or just knowing that you are at risk for bone loss, can allow you to take the preventative measures necessary to keep your bones strong.

Though you might not fall into one of the categories above, you can review your lifestyle risk factors for osteoporosis to see if you should be screened early or begin making changes to prevent bone loss.

Susan Brady is a Physical Therapist, Doctor of Integrative Medicine and holds a Post Master’s Certificate in Nutrition and Integrative Health. Practicing in the healthcare field for over 25 years, her background give hers a unique perspective in treating bone disorders. By providing a comprehensive approach, Susan can evaluate your risk factors and address all avenues for strengthening your bones. For more information on Susan and her practice visit http://nurturedbones.com.


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