Bone Scans and Bone Health Screenings
When should you get a bone density scan, and why?
Bone Scan T-Scores: When It's Time to Treat
The National Osteoporosis Foundation recommends treatment for:
- Postmenopausal women with T-scores less than -2.0, regardless of risk factors.
- Postmenopausal women with T-scores less than -1.5, with osteoporosis risk factors present.
In addition, anyone with a fragility fracture (a fracture from a minor injury) should be treated for osteoporosis. This is true regardless of the DEXA scan results.
Treatment generally begins with a bisphosphonate medicine (Actonel, Fosamax, Boniva, or Reclast). These drugs are proven to increase bone density and reduce the risk of fracture. Other options include:
- Estrogens (hormone replacement therapy)
In addition, the National Osteoporosis Foundation recommends 1,200 milligrams of daily calcium intake -- through diet and/or supplements.
When Should You Get a Bone Density Scan?
When, and how often, you should get a bone density scan depends on your age, risk factors, and whether you’ve already been diagnosed with thinning bones.
The general rule: anyone at risk for osteoporosis should get a bone density scan. Don’t wait for a fracture or a formal diagnosis.
Postmenopausal women are at highest risk, because estrogen (which falls after menopause) preserves bone strength. But men get osteoporosis, too. "They just get it later," says Mary Zoe Baker, MD, an endocrinologist and professor of medicine at the University of Oklahoma Health Sciences Center. Usually around age 70, "men start to catch up to women" in developing osteoporosis, according to Baker.
Major expert groups make the following recommendations for osteoporosis screening and bone scans:
Women over age 65: All women over the age of 65 should get a DEXA scan, according to the National Osteoporosis Foundation and the U.S. Preventive Services Task Force.
Postmenopausal women under age 65: For women under 65, a bone scan is not universally recommended. The National Osteoporosis Foundation recommends a bone scan for women with risk factors for osteoporosis:
- History of bone fracture as an adult
- Current smoking
- History of ever taking oral steroids for more than 3 months
- Body weight under 127 pounds
- Having an immediate family member with a fragility fracture (a broken bone from a minor injury, suggesting osteoporosis).