Osteoporosis screening is an imaging test that looks for signs of bone loss. It's also called a bone density scan or dual X-ray absorptiometry (DEXA) scan. It's a low-dose X-ray that measures calcium and minerals in your bones.

It helps us:

• Diagnose low bone mass (osteopenia)
• Diagnose porous bones (osteoporosis)
• Predict your risk of future fractures
• See if osteoporosis treatment is working

Current recommendations are that all women aged 65 and over should get a bone density scan every few years to check for signs of osteoporosis. Post-menopausal women under 65 may benefit from screening if they have one or more risk factors.

Certain factors can increase your risk of bone loss and osteoporosis. Even if you don’t qualify for screening, you may need a DEXA scan for other reasons.

These include:

• Fracturing a bone after age 50
• Family history of low bone mass or osteoporosis
• Bone growth problems as a child
• Early menopause
• Diabetes, thyroid conditions, digestive diseases, rheumatoid arthritis, HIV/AIDS, and eating disorders
• Hormone therapy for breast cancer or prostate cancer
• Prolonged use of medicines, including corticosteroids, thyroid hormone, aromatase inhibitors, medicines for epilepsy and proton pump inhibitors for GERD
• Long-term smoking, tobacco, or heavy alcohol use
• Physical inactivity or long periods of sitting or bed rest
• Low body weight under 127 pounds or body mass index (BMI) of 21 or less
• A significant loss in height

At Carilion, we use a central DEXA (c-DEXA) scan for osteoporosis testing. These scans image your lower spine and hip. It's the best test to predict your risk of fractures. You may also get a peripheral DEXA (p-DEXA) scan to check hand, wrist, forearm, or foot bone health.

Before

For 24 hours before the test, DO NOT take supplements or multivitamins with calcium or eat any calcium-added food or other products.

Most people who get a DEXA scan are in menopause, but if you need this scan for other reasons and are still ovulating, tell your care team if you are or could be pregnant.

We suggest you wear loose, comfortable clothing. Avoid metal buttons, belt buckles, and jewelry—you’ll need to remove them before your scan.

During

You lie on a soft table as the scanner passes over you. To take a clear image, you need to stay still. The scan is painless and only takes a few minutes.

After

A radiologist will review your scan and share their findings with your care team. Combined with tools to assess your bone health, these scans can detect bone density loss and fracture risk.

If you show signs of osteoporosis, your care team will walk you through your treatment plan. Your plan may include lifestyle changes and medicine.

Your bone density score will also decide when you need another DEXA scan.

Understanding your bone density score

Your radiologist will report your DEXA scan results as a T- or Z-score.

T-scores compare your bone density with that of a healthy young woman. We use T-scores for post-menopausal women or men 50 and over. A T-score of -1.0 or above (including positive numbers) means your bone is healthy.

You're at a higher risk of fractures with a more negative T-score. A T-score from -1.0 to -2.5 shows bone loss or osteopenia; below -2.5 suggests osteoporosis.

The Z-score compares your bone density with that of other people of the same age, sex, and race. We use this result in women who haven’t gone through menopause, men younger than 50 and kids.

Your bone mineral density is low if your Z-score is -2.0 or less (bigger negative numbers).