A bone density test can help you understand age-related changes in your bones that occur naturally over time or due to other conditions. As people grow older, bone mass or density declines, especially in women as they transition through menopause. Excessive bone loss increases your risk for bone diseases, including osteoporosis. Osteoporosis gradually weakens bones, leading to bone fragility and increased chance of fracture. Knowing what your bone density test results mean can help you stay ahead of osteoporosis and protect your bone health to reduce the chances of injury.
To help referring physicians diagnose osteoporosis, Charlotte Radiology uses dual-energy X-ray absorptiometry (DEXA) scans, known as the gold standard for bone density testing. DEXA scans can identify low bone density at an early stage to help ensure accurate test results and provide you and your physician with the most useful information to develop a treatment plan.
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Who is at Risk for Osteoporosis?
Osteoporosis is most common in women after menopause, making aging a common risk factor for developing osteoporosis. In fact, the National Council on Aging reports that 20% of bone mass can be lost in the five to seven years following menopause. Many other factors can increase your risk of bone loss and influence your bone density test results, including:
- Being a woman — over 80% of people with osteoporosis are estimated to be women
- Being white or Asian American
- Having a parent who had osteoporosis
- History of an eating disorder
- History of fractures
- Hormonal changes, including low estrogen levels after menopause
- Low body weight (small, thin frame)
- Lack of exercise
- Not getting enough calcium and vitamin D — important nutrients for bone health — in your diet
- Taking certain medications, such as steroids, anticonvulsants, and tamoxifen or aromatase inhibitors for breast cancer, among others
- Tobacco and alcohol use
Recognizing these risks, the U.S. Preventive Services Task Force (USPSTF) recommends bone density screening for all postmenopausal individuals aged 65 years and older. Additionally, younger individuals with a significant fracture risk also stand to benefit from a DEXA scan, ensuring early detection and management.
If you’re 50 or older or have started menopause, talk with your primary care physician about having a bone density test. They can help you decide whether it makes sense for you and, if so, how often you should have the test. Your provider will consider your risk factors and bone density test results as they plan with you how to help build bone strength and treat osteopenia or osteoporosis.
What Is a Bone Density Test?
Osteoporosis rarely shows symptoms until a considerable amount of bone mass has been lost. The most visible symptoms include loss of height along with a curvature of the upper back, highlighting the importance of testing to determine bone density.
These tests — also known as bone mineral density tests, or BMDs — measure minerals in your bones that help them stay strong and healthy, including calcium. The most common of these tests, the central DEXA scan, uses low-dose X-rays to measure mineral content in the spine and hips, which are most likely to break due to osteoporosis. Other types of bone density tests measure mineral density in peripheral bones, such as those in the wrist or fingers, or use different types of imaging, such as CT.
A DEXA scan is quick, simple and painless. During the test, you lie on a padded table while a movable mechanical arm passes above you and sends X-rays through the bones. This non-invasive, touchless scan takes about 15 minutes. A physician’s order is required for a DEXA scan.
Decoding Your Bone Density Test Results
A radiologist will review your images and send a report to your physician. Your bone density test results will include two scores: a T score and a Z score.
The T score compares your bone density with that of a healthy young adult. This score can help your physician make a diagnosis and determine if you need treatment. A negative score indicates that your bones are weaker than they should be and that you may be experiencing bone loss. Your score will fall into one of three categories:
- Normal: -1 or higher
- Osteopenia (low bone mass), a potential indicator of osteoporosis: -1.1 to -2.4
- Osteoporosis: -2.5 or lower
The Z score shows your bone density relative to other people of the same age, sex and size. A score of -2.0 or lower could mean you have osteoporosis.
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The Significance of Your Bone Density Test Results
Your bone density test results don’t just shed light on the current state of your bones. They also help you and your physician determine how to shape the healthiest future for your bones.
If your scan showed normal bone density, your bones are healthy, and you likely won’t need treatment. A low bone density score, on the other hand, means you’ll need to take steps to reduce bone loss and the risk of a fracture.
A diagnosis of osteoporosis isn’t a reason to panic. Rather, it’s a signal your bones need extra attention. Thanks to early detection through a bone density test, you’ll know what’s going on with your bones instead of having to find out, courtesy of an osteoporosis-related fracture. With your physician’s help, you can improve your bone health through a combination of exercise, including aerobic and resistance or strength training activities, changes in diet, hormone therapy or other medications known to improve bone health.
Next Steps After Your Test
If your bone density test results were normal, don’t rest on your laurels. Talk to your physician about what you can do to maintain bone health. Your physician may suggest participating in regular weight-bearing exercises, such as walking or incorporating light weights into your workout, which can strengthen your bones.
Your physician may recommend taking calcium and vitamin D supplements if you don’t get enough from your diet. You can find calcium in broccoli, low-fat dairy products, salmon and calcium-fortified foods. Vitamin D occurs in egg yolks and fatty fish. Some products, such as milk and cereals, are fortified with vitamin D. Studies aren’t clear on whether taking extra calcium and vitamin D can help lower the chance of fractures, so additional preventive measures should be used.
Weight-bearing exercise and proper nutrition also play a role in strengthening your body, including your bones. In addition, you can improve bone health by not smoking and limiting your alcohol intake to no more than one drink per day.
Healthy lifestyle changes alone may not be enough to prevent the progression of osteoporosis. Fortunately, several classes of medications are available to help slow bone loss and improve bone density. Your physician can help determine which treatment may be appropriate for you.
The Path to Better Bone Health
Whether your bone density test results show normal bone mass or excessive bone loss, having the information from a DEXA scan can be empowering. By developing healthy habits, such as exercising regularly, getting enough calcium and vitamin D in your diet, and following your physician’s screening and treatment recommendations, you can support healthy bones for the long term.
