Practical Prevention--Who Needs Bone Mineral Density Testing?
by Elizabeth Smoots, MD
Bone mineral density (BMD) testing has become more available in the US, so it's easier than ever to get checked for osteoporosis. Though a BMD test may not be appropriate for everyone, for some, it may provide an important prevention opportunity.
Contrary to popular belief, both men and women can develop osteoporosis, but it is far more common in women, especially after menopause. Osteoporosis slowly weakens bones and puts people at risk for fractures. As a result, nearly half of women and nearly one quarter of men over 50 will have a fracture due to osteoporosis during their remaining lifetime.
The consequences can be devastating. Spinal fractures may lead to stooped posture, loss of height, chronic pain and disability, and compression of the stomach or lungs. Hip fractures are even more dangerous. Each year, osteoporosis causes more than 2 million fractures of the spine, hip and wrist, causing pain, suffering, depression, difficulty functioning, and lower quality of life.
Promise of Prevention
Since osteoporosis is a silent disease, most people don't realize they have it until after they break a bone. However, there is a way to get an early warning about thinning bones that may allow you to take action. Machines that measure your bone density can help predict your future risk of fractures. Tests can detect osteoporosis before fractures, while preventive measures may still help.
How Bone Density Testing Works
Most devices that measure BMD rely on x-rays to take pictures of your bones. The procedure generally takes less than 15 minutes to complete, and exposes you to about one-tenth of the radiation used in a standard chest x-ray. A computer then calculates the test results to determine the bone density.
Several types of machines are available to read bone density. The most-accurate machines, called central machines, measure the density of your hip, spine, total body, or a combination of these sites. Peripheral machines, on the other hand, usually take measurements at only 1 location, such as your finger, wrist, kneecap, shinbone or heel.
BMD Testing Recommendations
Talk to your doctor about your risks for osteoporosis. Men and women should be evaluated individually to determine the need for BMD testing. People with multiple factors that place them at high risk for osteoporosis may benefit from early testing.
The National Osteoporosis Foundation recommends BMD for:
Postmenopausal women under the age of 65 years old, perimenopausal women, and men aged 50-69 years with at least one of the following:
Lifestyle risk factors, such as:
Inherited risk factors, such as:
Personal history of:
In BMD testing, the lower your results, or T-score, the higher your risk of developing a fracture. If you are unsure about your bone density status, talk to your doctor about osteoporosis screening. You may be able to avoid future fractures by getting tested.
American Congress of Obstetricians and Gynecologists
National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center
The Society of Obstetricians and Gynaecologists of Canada
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Last reviewed July 2017 by EBSCO Medical Review BoardMichael Woods, MD, FAAP
Last Updated: 7/24/2015
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