What is bone mineral density testing?
Bone mineral density testing is a way to see if your bones
are healthy and strong. A bone mineral density test is used
to measure the density (strength) of your bones. It is
different from a bone scan, which is used to look for
fractures or areas of bone inflammation.
Why is this test done?
Your health care provider orders a bone mineral density test
to check your bone health. It may be done for several
possible reasons:
- as a routine screening test
- when your risk for having weak bones is high
- after you have broken a bone to see if weak bones were a
cause of the break, which could mean you are at risk for
more broken bones.
Your bones naturally lose some density as you get older.
The loss of density weakens the bones. If your bones are
somewhat less dense than normal, you have osteopenia. If
your bones have lost a lot of density, you have
osteoporosis.
Each year there are approximately 700,000 spine fractures
and 250,000 hip fractures in the US. Most of these
fractures occur in people who have osteoporosis. To help
prevent such fractures, it is important to diagnose
osteoporosis. Osteoporosis can then be treated with diet,
exercise, and sometimes medicines to help make the bones
strong again.
Bone mineral density tests are much more sensitive than
normal x-rays. Normal x-rays do not detect bone loss until
at least 30% of the bone mass has been lost. Bone mineral
density tests allow health care providers to diagnose
weakening bones at earlier stages. The test helps your
health care provider decide if you need treatment for
osteoporosis.
How do I prepare for this test?
- You don't need to fast, stop taking any medicines, or
limit your activity in any way before the test.
- Don't wear clothing with buttons, snaps, or zippers from
the waist down on the day of the test. If you wear pants
with an elastic waistband or cloth tie, you won't need to
get undressed for the test.
- If you have recently had x-ray tests using barium or any
nuclear medicine tests, you should have your bone density
test at least a week after those tests.
- Tell your health care provider if you are or might be
pregnant.
How is the test done?
There are several different kinds of bone mineral density
tests. Some use sound waves (ultrasound). Others use small
amounts of radiation.
Dual energy x-ray absorptiometry (DXA or DEXA) is the most
commonly done of the tests that use radiation. It is
painless. During the test you lie down on a padded table.
It's best not to move while the test is being done, but you
can breathe normally. It takes just a few of minutes to
check the bone density of your spine and hip. (The hip and
spine are the most common areas checked because they are
most prone to fracture if your bones are weakened.) The
amount of radiation used for this test is very low. It is
about the same amount you would get on a long plane flight
and less than you are exposed to during a typical chest
x-ray.
There are other tests besides the DEXA scan. Different
tests have different strengths and weaknesses. Talk to your
health care provider about which test is right for you.
How will I get the test result?
Ask your health care provider when and how you will get the
result of your test.
What does the test result mean?
The test results are expressed as 2 types of scores:
- The T-score compares your bone mineral density (BMD) to
the expected bone density value of a healthy young adult
(about age 30) of the same sex and ethnicity.
- The Z-score compares your BMD to the BMD of a healthy
person who is about the same age and body size as you.
The T score is usually used to make treatment decisions
using a statistical measure called a standard deviation
(SD). The SD measures the difference between your BMD and
that of a healthy young adult (the reference value). Every
-1 SD ("minus 1 standard deviation") equals a 10 to 12%
decrease in bone density. T score results are classified as
follows:
 |
| Above -1 |
normal |
 |
| -1 to -2.5 |
osteopenia (low bone mass) |
 |
| Below -2.5 |
osteoporosis (very low bone mass) |
 |
The Z score is used to interpret the test results if you are
outside the normal testing range (very young or very old).
It is the number of standard deviations (SD) above or below
the reference value for your age.
What if my test result is not normal?
The result of your test has to be interpreted along with
your overall health, your risk factors for osteoporosis, and
your lifestyle. Your health care provider will take all of
these factors into account before deciding whether you need
treatment and what the treatment might be. For some people,
just getting more exercise and eating a better diet or
taking a calcium and vitamin D supplement is enough. Other
people need medicine to restore their bone density. You may
need to repeat the test again in a year or two to see if the
health of your bones has changed.
It's always a good idea to talk to your health care provider
about your results and make sure that you understand what
they mean. If your test results are not normal, ask your
health care provider:
- if you need additional tests
- what you can do to work toward a normal value
- when you need to be tested again.


Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File TST5139F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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