Bone Mineral Density: What To Think About

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What To Think About

• Experts disagree about which bones are best to use for BMD measurements. Bones in the lower spine and hip are tested most often. These bones generally have the most bone loss and are more likely to fracture. Sometimes bones in the wrist are measured. Ultrasound testing is done on the bone in the heel.
• A BMD measurement should be done only when the information provided by the test will affect treatment decisions. BMD does not need to be measured more often than every 2 years to find out how well treatment is working.
• Using DEXA to measure bone mineral density is replacing older methods, such as dual photon absorptiometry (DPA).
• Regular X-rays cannot detect mild bone loss. A bone must lose at least a quarter of its weight before a regular X-ray can detect the problem.
• If your bone density is lower than normal, you can increase bone density and strength by taking calcium and vitamin D supplements, exercising, lifting weights or using weight machines, and taking some medicines. For more information about how you can increase your bone strength and density, see the topic Osteoporosis.
• Measuring BMD is recommended for women age 65 and older, and for women ages 60 to 65 who have risk factors for osteoporosis.
• In the United States, legislation (called the Bone Mass Measurement Coverage Standardization Act) requires Medicare to pay for bone mineral density testing for people who have Medicare benefits and are at risk for losing bone mass. This includes:
  • Women who have gone through menopause and are at high risk for a bone fracture.
  • People who have increased bone loss (osteopenia) or have broken a bone because they have osteoporosis.
  • People using long-term doses of corticosteroids.
  • People using medicine to treat osteoporosis for 2 years or longer.
  • People who have hyperparathyroidism.

Last updated:	September 23, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Carla J. Herman, MD, MPH - Geriatrics
Editors:	Maria Essig, Tracy Landauer