Screening and Diagnosis
Diagnosing osteoporosis before a fracture occurs is far preferable to waiting for a fracture to occur. Osteoporosis can be easily diagnosed by a DXA (dual energy X-ray absorptiometry, also called bone mineral density) test, a simple 10 minute test using tiny amounts of radiation. The DXA is the best way to assess bone health and diagnose osteoporosis.
People who should have a DXA include women and men who:
- Have had a fracture following mild trauma (eg. slip and fall)
- Have low estrogen (women) or testosterone (men) levels
- Are on Prednisone chronically
- Have chronically overactive thyroid or parathyroid function
- Have elevated blood prolactin levels.
In addition, Dr. Streeten says that all women over 65 and all men over 70 should get a DXA test. In addition, she recommends that all post-menopausal women under age 65 who have other risk factors for fracture, should have a DXA.
Those other risk factors include being relatively thin (under 127 lbs for women), having a parent who had a hip fracture or a parent or sibling diagnosed with osteoporosis, having hyperthyroidism, smoking, excessive alcohol intake, and chronic use of prednisone or other medications known to increase the risk of osteoporosis (eg. anti-seizure medicines).
Generally, the DXA is done in pre-menopausal women and men under age 50 only when they are chronically on prednisone, have had a fragility fracture or have a known genetic disorder that increases fracture.
“According to the National Osteoporosis Foundation guidelines, reasons to treat with an osteoporosis medication are if the DXA T-score (standard deviation away from young normals at peak bone mass) is less than -2.0 and there are no other risk factors for fracture or if the T-score is less than ”“1.5 and there is another risk factor for fracture,” says Streeten.
A DXA test can be scheduled by calling the Department of Diagnostic Radiology's outpatient center (located at 419 W. Redwood Street) at 410-328-3225. An order from a doctor is required to get insurance coverage for the test. The DXA is also used to follow osteoporosis patients, to determine if they are responding to treatment.
To make an appointment with Dr. Streeten at the Metabolic Bone Diseases Clinic, please call 410-328-5196, 410-328-6219, or toll-free at 1-800-492-5538.