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Osteoporosis Osteoporosis Prevention

Bone Density: Should You Be Tested?

Summary & Participants

People with osteoporosis are often unaware that they have the disease until they sustain a fracture, which can result from the slightest accident. For this reason, screening for osteoporosis is an important health precaution for many women at risk. Tune in as we discuss bone density testing and those people who should consider getting screened for this silent disease.

Medically Reviewed On: July 10, 2008

Webcast Transcript

CAROLYN BECKER, MD: We actually know a lot of definite risk factors for osteoporosis. Just by being female you're at risk for having lower bone density. Certain races -- Caucasians and Asian women -- are much more susceptible. Also, dairy product intake -- if you didn't drink milk, if you have low calcium, that's a risk factor. Smoking, lack of exercise, lack of regular menstrual periods. There are a whole host of risk factors that your doctor and yourself should know about and be able to tell whether you are one of those people at very high risk for osteoporosis.

LISA CLARK: When would most doctors take a look at an apparently normal female patient and say you should have a bone density scan?

CAROLYN BECKER, MD: I really feel that osteoporosis is a pediatric disease that we often diagnose in adulthood. I'd like to start with our children and our young teenage girls, who often are not getting enough milk in their diet, and they're smoking and they're drinking diet sodas and so on and never building the bones they need for the rest of their lives. But generally at age 50, at the time of menopause, is when most women will get a bone density to determine whether they are at risk, whether they should take hormone therapy, or whether they are really in pretty good shape and don't need to do anything other than calcium and vitamin D and exercise.

LISA CLARK: Other than the DEXA test, what other tests might your doctor recommend to determine bone density?

CAROLYN BECKER, MD: We know that plain x-rays of the bone are a very poor way of diagnosing osteoporosis because you have to have lost 30 to 50 percent of your bone density before it will show up on a plain x-ray, like a chest x-ray. There are ultrasounds of the heel that are now being used. Some people will measure actually a metacarpal, or a part of your finger. There are other tests that are very good for screening to pick out those at highest risk, but they're not as good for really determining who has the most serious osteoporosis or who really have regional osteoporosis, because they only measure one site, so we prefer the DEXA.

LISA CLARK: If you have a DEXA and it shows that you're in pretty good shape, how soon would you have that test repeated?

CAROLYN BECKER, MD: It depends on your risk factors. Let's say you're in good shape but you're going to start on steroids or glucocorticoids for asthma or some condition. You may actually need another DEXA in six to 12 months. For most people, we recommend going two to three years if they're in good shape before they get their next DEXA.

LISA CLARK: And Medicare is a consideration for a lot of women who are vulnerable to osteoporosis. How frequently can the test be performed and be paid for?

CAROLYN BECKER, MD: Medicare will actually pay for a DEXA every two years, but if you start a Medicare age patient on treatment, you can actually justify getting it sooner. In fact, in one year you can get a second DEXA to make sure the treatment you've initiated is working.

LISA CLARK: Where do you go to find about getting bone density screening? Is this something that is becoming a common practice? Sometimes you'll see mammograms that are done in a mobile truck. Is that starting to happen with bone density?

CAROLYN BECKER, MD: Yes, I think there are some mobile trucks with bone density -- not the DEXA, because that's hard to be mobile, but some of the more peripheral studies. The best resource, of course, is your doctor.

LISA CLARK: Right.

CAROLYN BECKER, MD: A second resource would be to go to the National Osteoporosis Foundation on the Web, or write to them or call them. Most people should at some point in their lives.

LISA CLARK: Stay informed.

CAROLYN BECKER, MD: Absolutely.

LISA CLARK: Dr. Carolyn Becker, thank you so much for joining us.

CAROLYN BECKER, MD: My pleasure, Lisa.

LISA CLARK: And our thanks to you for joining us on this webcast. I'm Lisa Clark.

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