Bone Density Scan (cont.)
Jason C. Eck, DO, MS
Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.
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.
In this Article
- What is osteoporosis?
- How does osteoporosis occur?
- What is "bone mineral density" (BMD)?
- Why is BMD measurement important?
- What is the relationship between BMD and fracture risk?
- Who should have BMD testing?
- How is BMD measured?
- What are other methods of measuring BMD?
- How often should DEXA scans be repeated to monitor treatment?
- What is the cost of DEXA?
- What about the accuracy of BMD testing in the doctor's office using smaller equipment?
- Bone Density Scan At A Glance
- Find a local Rheumatologist in your town
What is the cost of DEXA?
The cost for DEXA scanning varies depending on insurance policies and coverage. In general, a patient without coverage paying cash can expect to pay approximately $200 U.S. for the procedure.
What about the accuracy of BMD testing in the doctor's office using smaller equipment?
There are several devices that are smaller than the standard DEXA scanners that are being used in doctors offices to screen for low bone density. Very little scientific data is available about these smaller units. Most of the information comes directly from the equipment manufacturers themselves. Many of these models test peripheral bones in the feet or hands. Other units use ultrasonography. These techniques can be less accurate than BMD testing performed with state of the art equipment. Additionally, office-testing equipment can range dramatically in price and quality.
In general, these devices may be reasonable to measure overall fracture risk but are not useful in monitoring therapy. Their use might be limited to screening and results would require confirmation using DEXA. In addition, expertise in using the equipment and interpreting the data can vary. At present, it is difficult to comment on these other methods of BMD testing. Some doctors use these as screening tools and recommend more formal DEXA testing if they are abnormal.
Osteoporosis is a disease that results in a significant risk of fracture. The consequences of fracture can include hospitalization, immobility, a decrease in the quality of life, and even death. From a larger perspective, it is a costly disease in terms of the health-care system and time lost from work. Early detection and therapy is the mainstay for trying to prevent these complications. BMD testing results correlate well with the risk of fracture, and the testing is easily performed in a time-efficient manner without any discomfort. Although many methods of BMD testing exist, the best currently is DEXA scanning. It is imperative that testing ultimately be done using state-of-the-art equipment with capable highly-trained personnel and a doctor well versed in interpreting the results.
- 40% of postmenopausal women in the U.S. have osteopenia (low bone density). An additional 7% have osteoporosis.
- In 1995, osteoporosis-related fractures were associated with over 400,000 hospitalizations, stressing the importance of early detection and appropriate prescription therapy.
- Bone mineral density (BMD) estimates the true mass of bone.
- BMD analysis is recommended for women between ages 50 and 65 with risk factors for osteoporosis and for all women over the age of 65. In addition, men and women taking certain medications or having certain diseases should discuss testing with their doctor.
- By measuring BMD, it is possible to predict fracture risk in the same manner that measuring blood pressure can help predict the risk of stroke.
- DEXA is quick, painless and the preferred method to measure BMD.
- Osteoporosis has many available prescription and nonprescription treatment options once the diagnosis is made.
Previous contributing author: Medical Revising Author: Carolyn J. Crandall, MD, FACP
Cummings, et al. Am J Med 2002.
Gelbach, et al. Osteoporosis International 2003.
Marshall, et al. BMJ 1996.
National Osteoporosis Foundation Physician's Guide to Prevention and Treatment of Osteoporosis 2003.
Sarkar, et al. JBMR 2001.
Siris, et al. JAMA 2001.
Watts, et al. J Clin Densitom 2004.
Last Editorial Review: 4/11/2008
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