How do I get a bone density check? A complete guide

Over 54 million Americans are living with osteoporosis or low bone mass, a condition that significantly increases fracture risk. Understanding how to get a bone density check is a critical first step in protecting your skeletal health, especially as you age. This guide provides authoritative information on the process, ensuring you know exactly what to do next.

Quick Summary

Obtaining a bone density check begins with a consultation with your primary care physician, who will assess your risk factors and provide a referral for a DEXA scan. The process involves confirming your eligibility, scheduling the appointment at a testing center, and discussing the results with your doctor to create a proactive bone health plan. It is a straightforward, non-invasive procedure vital for assessing fracture risk.

Key Points

• Consult your doctor: A bone density check requires a referral from your primary care physician.

• Know your risks: Your doctor will assess your age, gender, lifestyle, and medical history to see if you are a candidate.

• Understand the test: The most common check is a DEXA scan, a quick, painless X-ray of the hip and spine.

• Prepare for the scan: Wear loose clothing and avoid calcium supplements for 24 hours before your appointment.

• Analyze the results: Your doctor will interpret your T-score to determine if you have normal bone density, osteopenia, or osteoporosis.

• Follow up on results: Based on your results, you can discuss next steps, which may include diet, exercise, or medication.

Your First Step: The Doctor’s Visit

Your journey to a bone density check, formally known as a DEXA (Dual-Energy X-ray Absorptiometry) scan, begins with a conversation with your primary care physician. This is not a test you can simply request on your own. Your doctor will evaluate your personal risk factors to determine if a DEXA scan is appropriate for you.

Who Should Consider a Bone Density Check?

While the test is often associated with postmenopausal women, several factors can make a person a candidate for screening.

Risk Factors for Bone Density Loss

• Age and Gender: Women over 65 and men over 70 are typically recommended for screening.
• Fracture History: A previous fracture from a minor fall can be a significant indicator.
• Low Body Weight: Individuals with a low body mass index (BMI) are at higher risk.
• Family History: A parent or sibling with osteoporosis or a history of fractures.
• Medications: Long-term use of certain drugs, such as corticosteroids, can weaken bones.
• Lifestyle Factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle contribute to bone loss.
• Medical Conditions: Rheumatoid arthritis, kidney disease, and celiac disease can affect bone health.

The Referral Process

Once your doctor determines you are a good candidate, they will provide a referral. This is a standard procedure that authorizes the specialized test. Your doctor's office will often assist you in scheduling the appointment or provide you with a list of reputable testing centers.

Understanding the DEXA Scan

The DEXA scan is the gold standard for measuring bone mineral density. It is a quick, painless, and non-invasive procedure.

What to Expect During the Exam

1. Preparation: Wear comfortable, loose-fitting clothing without metal zippers or buttons.
2. The Scan: You will lie on a padded table while a low-dose X-ray arm passes over your lower spine and hip.
3. Duration: The entire test typically takes only 10 to 20 minutes.
4. No Pain: The procedure is completely painless, and you can breathe normally throughout.

What Do the Results Mean?

The DEXA scan provides a T-score, which compares your bone density to that of a healthy young adult, and a Z-score, which compares your results to others in your age group. These scores are crucial for diagnosing osteoporosis or osteopenia.

Comparison of Bone Density Testing Methods

While DEXA is the most common, other methods exist, though they are less comprehensive.

Test Method	Pros	Cons	Use Case
DEXA Scan	Highly accurate, measures hip and spine, gold standard.	Requires a medical referral, limited access in some areas.	Diagnosis of osteoporosis, monitoring treatment.
Peripheral DEXA (pDEXA)	Portable, lower cost, quicker than a full DEXA.	Measures density at the heel, wrist, or finger only; not for diagnosis.	Screening tool, not definitive diagnosis.
Quantitative Ultrasound (QUS)	No radiation, portable, low cost.	Measures density at the heel; less accurate than DEXA.	Screening tool, not definitive diagnosis.

Preparing for Your Appointment

Following a few simple steps can ensure an accurate reading.

1. Inform Your Provider: Tell the testing center if you are pregnant or have recently had a barium study or a contrast dye injection.
2. Calcium Supplements: Avoid taking calcium supplements for 24 hours before your test.
3. Medications: Continue all other medications as prescribed unless your doctor instructs otherwise.

What if Your Insurance Doesn’t Cover It?

Some health insurance plans, including Medicare, cover bone density checks for specific at-risk groups. If you do not meet the criteria for coverage, you can still get a test. Some hospitals offer reduced rates, and you can often find local clinics offering special pricing. Always call your insurance provider first to understand your specific benefits and coverage details.

After the Test: Your Path Forward

After your scan, your doctor will discuss your T-score and recommend a course of action. This may include lifestyle changes, nutritional adjustments, or medication, depending on your results.

Strategies for Strong Bones

• Diet: Ensure an adequate intake of calcium and vitamin D.
• Exercise: Engage in weight-bearing exercises like walking, jogging, and strength training.
• Healthy Habits: Avoid smoking and limit alcohol consumption.

Your doctor may also refer you to a specialist, such as an endocrinologist, if your results indicate a more complex issue. For more comprehensive information on bone health and osteoporosis, you can visit the National Osteoporosis Foundation website.

Conclusion

Getting a bone density check is a proactive step in managing your health, especially as you get older. By starting with a conversation with your doctor, following the referral process, and preparing for the DEXA scan, you can gain valuable insight into your bone health. This empowers you to make informed decisions and take preventative measures to protect against fractures and maintain your quality of life.

Frequently Asked Questions

At what age should I start thinking about how to get a bone density check?

Screening is generally recommended for all women aged 65 and older and men aged 70 and older. However, your doctor may recommend an earlier check if you have significant risk factors.

How long does a bone density check take?

The most common test, a DEXA scan, is very quick. The entire procedure usually takes only 10 to 20 minutes from start to finish.

Does getting a bone density check hurt?

No, a DEXA scan is a painless and non-invasive procedure. You simply lie still on a padded table while the scan is performed.

How often should I get a bone density check?

The frequency depends on your initial results and risk factors. If your initial results are normal, your doctor may recommend a recheck every 2 to 5 years. If you have osteopenia or osteoporosis, more frequent monitoring may be needed.

Can a bone density check be done with a simple X-ray?

No, a standard X-ray can show fractures but cannot accurately measure bone mineral density. A DEXA scan uses a special low-dose X-ray to specifically measure bone density.

What is the difference between a T-score and a Z-score on a bone density test?

A T-score compares your bone density to that of a healthy young adult of the same gender, while a Z-score compares your density to that of other people in your age group. The T-score is typically used for diagnosing osteoporosis.

Will my insurance cover the cost of a bone density check?

Most health insurance providers, including Medicare, cover bone density checks for individuals who meet specific risk criteria. It is best to check with your insurance company beforehand to confirm your coverage.