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Medical Author:

Howard R Smith, MD

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Early detection of low bone mass (osteopenia) or osteoporosis is the most important step for treatment to be effective. If osteopenia or osteoporosis is diagnosed, a person can take action to stop the progression of bone loss. Knowing the risk factors for osteoporosis in order to begin effective prevention or treatment is important.

Certain factors, such as female sex, family history of osteoporosis, small body size, and an inactive lifestyle, are associated with an increased risk of developing osteoporosis. Take the one-minute osteoporosis risk test from the International Osteoporosis Foundation to find out more. If any of these risk factors or other signs of osteoporosis exist, the doctor may recommend measuring bone mass. Because the most common sites of fractures due to osteoporosis are the spine, wrist, and/or hip, bone mineral density (BMD) tests often measure the solidness and mass of bone (bone density) at those sites, as well as in the heel or hand. Bone mineral density tests are performed like X-rays. They are painless, noninvasive, and safe.

Bone mineral density test results are helpful to do the following:

• Detect low bone density (osteopenia), which can predict the chance of developing a fracture
• Confirm a diagnosis of osteoporosis

• Determine the rate of bone loss and monitor the effects of treatment (tests done to monitor treatment are usually conducted every year or so)

Several tests are available to assess bone density. These tests are not painful, and they are noninvasive (meaning that they do not involve surgery). The most common types of tests are listed below:

• Dual energy X-ray absorptiometry (DXA or DEXA) scanning is a special low radiation X-ray that can detect even very small amounts of bone loss. DXA scans are the most commonly used method of bone mineral density measurement. They often are used to measure spine and hip bone densities. Two other types of scans are the following:
• Peripheral dual energy X-ray absorptiometry (pDXA) measures the bone density in the forearm, finger, and heel.
• Single-energy X-ray absorptiometry (SXA) measures the bone density in the heel.
• Quantitative computed tomography (QCT) scanning measures the bones of the lower spine, which change as a person ages. The peripheral QCT scan can measure the forearm bone density.
• Quantitative ultrasound (QUS) uses sound waves to measure bone density at the heel, shin, and finger.

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