Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?

Osteoporosis is a disease that affects your bones. It means that your bones are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, wrist, and other parts of your body. These fractures can be disabling and may make it hard for you to live on your own.

The DXA is an X-ray test that measures bone thickness. It is used to see if your bones are getting thin and brittle, which means they could break more easily.

The results of the test may show that you need treatment for osteoporosis.

A risk factor is anything that can increase your risk of getting a disease. Some risk factors you can change so that you reduce your risk. Others you can't change.

Risk factors you can't change include:

• Your age. Your risk for osteoporosis goes up as you get older.
• Being a woman who has gone through menopause. After menopause, your body makes less estrogen. Estrogen protects the body from bone loss.
• Your family history. Osteoporosis tends to run in families.
• Having a slender body frame.
• Your race. People of European and Asian background are most likely to get osteoporosis.
• Your health. You may be at higher risk if you have a medical problem such as hyperthyroidism that makes it hard for your body to absorb enough calcium.
• Having surgery to remove your ovaries before menopause.

Risk factors you can change include:

• Smoking.
• Not getting enough weight-bearing exercise, such as running, walking, or lifting weights.
• Drinking large amounts of alcohol.
• Not getting enough calcium and vitamin D.
• Using steroid medicines for 6 months or longer. But you may not be able to stop taking these, depending on why you are taking them.

The United States Preventive Services Task Force (USPSTF) recommends that women age 65 or older have routine tests to measure their bone thickness. If you are at increased risk for fractures caused by osteoporosis, routine screening should start sooner.^{footnote 1} USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and when to start bone density screening.

The FRAX tool can help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone density test on your hip, you can type in your score. If you have not had that test, you can leave the score blank.

Here are some other things to think about:

• You may also want to have this test if you have a low-trauma fracture. Low trauma means that you broke a bone doing something that would not normally cause a broken bone, such as a simple fall.
• Experts suggest that older men talk to their doctors about whether a bone density test is right for them. It may depend on their risk for fractures.^{footnote 1, footnote 2}
• Your doctor may want you to have a follow-up bone density test, for example, a year or two after your treatment started. Getting follow-up tests doesn't make your treatment work better.

If you have risk factors for osteoporosis and choose to get the test, the results can help you make decisions about treatment. Treatment can help strengthen bones and prevent fractures.

If you are younger than 65 and don't have any risk factors for osteoporosis, this test won't be very useful. You may want to have the test when you reach age 65. But in the meantime, if you are worried about getting osteoporosis, talk with your doctor about lifestyle changes you can make to keep your bones strong.

If you are at risk for osteoporosis and have a healthy lifestyle but are not willing to take medicines for treatment, the test may not be helpful. The results of the test would not change what you are already doing to keep your bones strong.

Your doctor may advise you to get this test if:

• You are 65 or older and have other risk factors for osteoporosis.
• You broke a bone doing something that would not normally cause a broken bone, such as a simple fall.
• You are willing to make changes to your lifestyle or take medicines if the test shows that you have osteoporosis.