How is a bone density test done on a man?

While osteoporosis is often considered a women's health issue, approximately one in four men over 50 will break a bone due to the condition. Learning how is a bone density test done on a man is a proactive step in managing bone health, identifying risks early, and preventing future fractures.

Quick Summary

A bone density test, or DEXA scan, for a man involves a simple, painless, and non-invasive procedure where he lies on a padded table while a low-dose X-ray machine scans his spine and hips to measure bone mineral density.

Key Points

• DEXA Scan is the Standard: The most common and accurate method for measuring bone density in men is a dual-energy X-ray absorptiometry (DEXA) scan, which is quick and painless.

• Focuses on Critical Areas: The central DEXA scan measures bone density in the lower spine and hips, which are the most common sites for osteoporosis-related fractures.

• Simple Preparation: Preparation for the test is minimal and includes avoiding calcium supplements for 24 hours and wearing comfortable clothing without metal.

• Positioning for Accuracy: During the procedure, you will lie on a padded table while a scanner passes over your body, with positioning adjustments to get clear images of your spine and hips.

• Results Guide Treatment: The results are given as T-scores and Z-scores, which help doctors diagnose low bone mass (osteopenia) or osteoporosis and determine the best treatment plan.

• Vital for Men with Risk Factors: While routine screening is recommended for men over 70, those with specific risk factors, such as long-term steroid use or low testosterone, may need earlier testing.

Understanding the Bone Density Test (DEXA Scan)

A bone density test is a specialized, low-dose X-ray procedure most commonly known as a DEXA (Dual-Energy X-ray Absorptiometry) scan. Unlike a regular X-ray that provides a visual of the bones, a DEXA scan measures the bone mineral content and density (BMD), which is crucial for assessing bone strength and fracture risk. Although osteoporosis affects men less frequently than women, its impact can be significant, making this test a vital diagnostic tool, especially for men over 70 or those with specific risk factors.

Preparation for a Bone Density Scan

Proper preparation helps ensure the accuracy of the test results. The steps are straightforward and minimal, designed to avoid any metal interference with the X-ray technology. Following these guidelines will make your appointment smoother and more effective.

• Dietary Restrictions: You may be asked to avoid taking calcium supplements or multivitamins for at least 24 hours before your exam. You can typically eat and drink normally, but it's best to confirm specific instructions with your provider or imaging center.
• Medication Review: Inform your doctor and the technician of any medications you are taking, as some, like long-term steroids, can affect bone health and risk assessment. If you have recently had a contrast study (like a barium exam), you may need to wait up to a week.
• Clothing and Jewelry: Wear loose, comfortable clothing without any metal parts, such as zippers, buckles, or metal buttons. For convenience, a sweatsuit or similar sportswear is ideal. You will also need to remove all metal jewelry, eyeglasses, or body piercings that are in the scanning area.

The Central DEXA Scan Procedure

The central DEXA scan is the most common and accurate method, focusing on the hip and lower spine, the areas most prone to fractures due to osteoporosis. The procedure is quick, painless, and typically takes around 15 to 20 minutes.

Here is a step-by-step breakdown of what a man can expect during the test:

1. Check-in and Intake: After arriving at the radiology department or clinic, you will be checked in by a technologist who will confirm your details and explain the process.
2. Positioning: You will lie flat on your back on a padded table. The technologist may place a padded box or foam block under your knees to help straighten your pelvis and flatten your lower spine for the most accurate reading.
3. Scanning the Spine: A scanning arm will slowly pass over your lower body, specifically your lower spine. At the same time, a detector under the table will capture the low-dose X-rays that pass through your bones.
4. Scanning the Hip: The technologist will then adjust your position slightly. Your foot will be placed in a brace to rotate your hip inward, allowing the machine to get a clear image of the hip joint.
5. Remaining Still: You will be asked to lie very still and may be asked to hold your breath for a few seconds during each scan. This is critical to prevent motion artifacts that could blur the images.
6. Completion: Once the scans of the spine and hip are complete, the test is over. You can get up immediately and resume your normal activities.

Results and Interpretation

After the radiologist reviews your scans, they will send a report to your doctor. The report will include two key scores: the T-score and the Z-score.

• T-score: This compares your bone mineral density to that of a healthy young adult of the same sex. A negative T-score indicates bone loss. For men over 50, this is the primary diagnostic tool.
  • Normal: T-score of -1.0 or higher.
  • Osteopenia (low bone mass): T-score between -1.0 and -2.5.
  • Osteoporosis: T-score of -2.5 or lower.
• Z-score: This compares your bone density to the average for your age, sex, and ethnicity. For men under 50, this is more relevant. A Z-score below -2.0 suggests that your bone density is lower than expected for your age group.

Central vs. Peripheral DEXA Scans

While the central DEXA is the gold standard, a peripheral DEXA scan is sometimes used. The following table compares the two methods to help you understand why your doctor might choose one over the other.

Feature	Central DEXA	Peripheral DEXA (p-DEXA)
Measurement Site	Lower spine and hip	Wrist, finger, or heel
Accuracy	High; considered the gold standard for diagnosis	Lower; often used for preliminary screening
Equipment Type	Large machine, typically found in a hospital or clinic	Small, portable device used in doctor's offices or health fairs
Purpose	Diagnoses osteoporosis, monitors treatment effectiveness	Screens for fracture risk, but requires central DEXA for confirmation
Radiation Dose	Very low, comparable to background radiation	Very low
Cost	Typically higher than p-DEXA	Often lower than central DEXA

When is a Bone Density Test Recommended for Men?

While guidelines for men's bone density screening can vary, doctors often recommend testing based on age and specific risk factors. Men aged 70 and older are generally advised to have a DEXA scan. However, screening may be considered earlier for men aged 50-69 with additional risk factors, which include:

• A fragility fracture (a break from minimal trauma)
• Low body weight
• Height loss (more than 2 inches)
• Family history of osteoporosis
• Long-term use of certain medications (e.g., corticosteroids)
• Low testosterone levels
• Lifestyle factors like smoking and excessive alcohol intake
• Chronic medical conditions like kidney disease or diabetes

Your healthcare provider will perform an individual risk assessment to determine if a DEXA scan is necessary for you.

For more information on bone health in men, you can consult resources like the Mayo Clinic's guide on bone density testing. This proactive approach ensures early detection, allowing for lifestyle adjustments and potential treatment to maintain strong, healthy bones throughout your life.

Life After the Test

After your bone density test, the results will help your doctor determine the best course of action. If your T-score is normal, you will likely continue with healthy lifestyle habits and a follow-up scan in a few years. If you have osteopenia or osteoporosis, your doctor may recommend dietary changes (more calcium and vitamin D), increased weight-bearing exercise, and potentially medication. Early detection through this simple test is the first and most critical step toward protecting your mobility and independence.

Conclusion

A bone density test is a crucial diagnostic tool for men, particularly as they age or have increased risk factors for osteoporosis. The DEXA scan is a quick, painless, and non-invasive procedure that provides valuable information about bone strength. By understanding the preparation, the procedure itself, and what the results mean, men can take charge of their bone health and work with their healthcare providers to develop a plan that minimizes fracture risk and supports healthy aging. Proactive screening and early intervention are the keys to maintaining a robust and active life. Mayo Clinic: Bone density test overview

Frequently Asked Questions

At what age should a man get a bone density test?

Current guidelines vary, but a bone density test is generally recommended for men aged 70 and older. However, men with significant risk factors for osteoporosis may need testing between the ages of 50 and 69.

Is a bone density test the same for men and women?

The procedure for a central DEXA scan is the same for both men and women. The primary differences lie in the timing of initial screening and the interpretation of the T-score, which is compared to young adults of the same sex.

Is a bone density test painful?

No, a bone density test is not painful. The procedure is non-invasive, and you simply lie on a padded table while the scanner arm passes over your body.

How long does a bone density test take?

A typical central DEXA scan, which examines the hip and spine, takes approximately 15 to 20 minutes to complete.

What is the T-score for a man with osteoporosis?

For men over 50, a T-score of -2.5 or lower indicates osteoporosis. A T-score between -1.0 and -2.5 is considered osteopenia (low bone mass).

What is the difference between a DEXA scan and a regular X-ray?

A DEXA scan uses a special low-dose X-ray to specifically measure bone mineral density and strength. A regular X-ray, in contrast, provides an image of the bones but does not measure density.

Can I eat normally before my bone density test?

Yes, you can typically eat normally before your exam. However, it is important to avoid taking calcium supplements or vitamins for at least 24 hours prior to the test.

How should I prepare for a bone density test as a man?

To prepare, avoid calcium supplements 24 hours beforehand, wear comfortable clothing without metal fasteners, and remove all jewelry. Inform the technologist if you have any metal implants or have recently had a contrast study.