A bone density test can help detect osteoporosis before a fracture happens. Also known as a DEXA scan or DXA scan, this quick and noninvasive imaging test measures bone mineral density and helps your healthcare provider estimate how strong your bones are and whether you may have an increased risk of fractures.
Many people do not know they have low bone density because osteoporosis often develops without obvious symptoms. For that reason, knowing when to get a bone density test is especially important for older adults and anyone with risk factors that may weaken the bones over time.
What Is a Bone Density Test?
A bone density test measures the amount of mineral contained in your bones. The most common method is dual-energy X-ray absorptiometry, usually called a DXA or DEXA scan. The test typically measures bone mineral density in areas that are especially vulnerable to osteoporosis-related fractures, such as the hip and spine.
A DEXA scan uses a very low level of X-rays and is generally painless. During the exam, you lie on a padded table while the scanner measures your bone density. The test can help diagnose osteoporosis, identify low bone mass or osteopenia, estimate future fracture risk, and monitor changes in bone density over time.
At What Age Should You Get a Bone Density Test?
Age is one of the most important factors considered when deciding whether osteoporosis screening is appropriate. The U.S. Preventive Services Task Force recommends osteoporosis screening for women age 65 and older. It also recommends screening postmenopausal women younger than 65 who have an increased risk of an osteoporotic fracture based on a clinical risk assessment.
Recommendations for men are less uniform. The USPSTF states that current evidence is insufficient to determine whether routine osteoporosis screening in men provides a clear overall benefit. However, other bone health organizations recommend discussing bone density testing beginning around age 70 or earlier when significant risk factors are present.
Age alone is not the only reason your doctor may recommend a DEXA scan. Your medical history, previous fractures, medications, lifestyle, family history, and other health conditions may make bone density testing appropriate at a younger age.
Signs You May Need a Bone Density Test
Osteoporosis is sometimes called a silent condition because bone loss itself usually does not cause noticeable symptoms. In many cases, the first indication of weakened bones is a fracture. Because of this, a bone density test is often recommended based on risk factors rather than symptoms.
However, certain changes or medical events may indicate that your bone health should be evaluated.
A Fracture After a Minor Fall or Injury
Breaking a bone after a relatively minor fall can be a warning sign of reduced bone strength. These fractures, sometimes called fragility fractures, may occur after an injury that would not normally be expected to break a healthy bone.
Adults who experience fractures later in life may need further evaluation to determine whether osteoporosis or low bone density contributed to the injury. The Bone Health & Osteoporosis Foundation recommends discussing bone density testing if you have broken a bone after age 50.
Loss of Height
Gradual loss of height can occur for several reasons, but significant height loss may sometimes be related to compression fractures in the spine. These fractures can happen when weakened vertebrae begin to collapse.
Because vertebral fractures do not always cause severe pain, some people may not realize they have one. If you have noticed a considerable change in your height, your healthcare provider may evaluate your spine and bone density.
A Stooped or Curved Posture
Changes in posture, including a progressively rounded upper back, can sometimes be associated with vertebral compression fractures caused by osteoporosis. While posture changes can have many causes, unexplained changes may be a reason to discuss osteoporosis screening with your doctor.
Unexplained Back Pain
Sudden or persistent back pain can occasionally result from a vertebral compression fracture. This is especially important in older adults or people who already have osteoporosis risk factors.
Back pain alone does not mean that you have osteoporosis, but a healthcare provider may recommend imaging or a bone density test if your symptoms and medical history suggest weakened bones.
Major Risk Factors for Osteoporosis
Certain factors increase the likelihood of developing low bone density and osteoporosis. Having one risk factor does not automatically mean you need a DEXA scan, but having several may make earlier screening appropriate.
Menopause
Estrogen plays an important role in maintaining bone strength. After menopause, estrogen levels decline, which can accelerate bone loss.
For this reason, postmenopausal women younger than 65 may be screened when clinical risk assessment indicates an increased risk of osteoporosis or fracture.
Family History of Osteoporosis or Hip Fracture
Genetics can influence bone density and fracture risk. Having a parent or close family member with osteoporosis or a history of hip fracture may increase your own risk.
Your healthcare provider may consider family history along with your age, body weight, medical history, and other factors when deciding whether bone density screening is appropriate.
Previous Fractures
A history of fractures, especially fractures caused by relatively minor injuries, may indicate reduced bone strength. Previous fractures can also increase the likelihood of experiencing another fracture later.
If you have broken a bone after age 50, discussing osteoporosis screening with your healthcare provider is especially important.
Long-Term Steroid Use
Certain medications can contribute to bone loss. Long-term use of glucocorticoids such as prednisone is one of the most recognized medication-related risk factors for osteoporosis.
People who need these medications for extended periods may require earlier or more frequent monitoring of bone density. Other medications may also affect bone health, so it is important to review your complete medication history with your healthcare provider.
Low Body Weight
People with low body weight or a small body frame may have less bone mass available to lose as they age. Significant or unexplained weight loss may also contribute to concerns about nutritional deficiencies and bone health.
Body weight is only one part of fracture risk, so it should be considered together with other medical and lifestyle factors.
Smoking
Smoking is associated with poorer bone health and an increased risk of fractures. Tobacco use can interfere with normal bone remodeling and may contribute to reduced bone density over time.
People who smoke and have additional osteoporosis risk factors may benefit from discussing bone density screening with their healthcare provider.
Excessive Alcohol Consumption
Heavy alcohol use can negatively affect bone formation, nutrition, balance, and fall risk. Together, these factors may increase the likelihood of fractures.
The Bone Health & Osteoporosis Foundation includes excessive alcohol intake among the risk factors that may lead healthcare providers to consider bone density testing.
Vitamin D Deficiency
Vitamin D helps the body absorb calcium and plays an important role in maintaining healthy bones. Persistent vitamin D deficiency may contribute to reduced bone strength, particularly when combined with other nutritional or medical risk factors.
Your healthcare provider may recommend laboratory testing, dietary changes, supplementation when appropriate, or further evaluation depending on your individual situation.
Conditions That Affect Nutrient Absorption
Certain gastrointestinal conditions can make it harder for the body to absorb calcium, vitamin D, and other nutrients needed for healthy bones. Disorders associated with malabsorption may therefore contribute to osteoporosis risk.
People with chronic digestive conditions, significant nutritional deficiencies, or a history of certain gastrointestinal surgeries may need closer monitoring of their bone health.
Frequent Falls
Bone density is only one factor that determines fracture risk. Frequent falls can significantly increase the likelihood of breaking a bone, particularly in older adults.
If you have problems with balance, muscle weakness, vision, mobility, or medications that increase your risk of falling, your healthcare provider may evaluate both your fracture risk and your bone health.
Can You Have Osteoporosis Without Symptoms?
Yes. Many people with osteoporosis feel completely healthy until they experience a fracture. Bone loss usually happens gradually and does not necessarily cause pain while it is developing.
This is why osteoporosis screening guidelines focus heavily on age and risk factors rather than waiting for symptoms to appear. Detecting low bone density early can give your healthcare provider an opportunity to evaluate your fracture risk and discuss appropriate ways to protect your bones.
What Happens During a DEXA Scan?
A DEXA bone density scan is usually simple and does not require an invasive procedure. You will typically lie on your back on an examination table while a scanning arm passes over the area being measured.
The hip and lower spine are commonly evaluated because fractures in these areas can have serious consequences. The examination generally takes only a short time, and you can usually return to your normal activities afterward.
You should tell the imaging center if you are pregnant or think you could be pregnant. You may also receive preparation instructions if you recently had certain imaging studies involving contrast material.
How Are Bone Density Test Results Interpreted?
Bone density results are commonly reported using a T-score. A T-score compares your bone density with the average bone density of a healthy young adult.
A T-score of -1.0 or higher is generally considered normal. A score between -1.0 and -2.5 is typically classified as low bone mass, also called osteopenia, while a T-score of -2.5 or lower is generally consistent with osteoporosis in the appropriate clinical setting.
Your healthcare provider will not necessarily make treatment decisions based on the T-score alone. Age, fracture history, medications, medical conditions, fall risk, and other factors may also be considered when evaluating your overall fracture risk.
Is Osteopenia the Same as Osteoporosis?
No. Osteopenia means that bone density is lower than normal but has not reached the level typically used to diagnose osteoporosis.
Not everyone with osteopenia will develop osteoporosis, but lower bone density may increase fracture risk. Your doctor may recommend lifestyle changes, medical evaluation, follow-up bone density testing, or treatment depending on your overall risk profile.
How Often Should You Get a Bone Density Test?
There is no single testing interval that is appropriate for everyone. The timing of a repeat DEXA scan depends on your original results, age, medical history, osteoporosis risk factors, medications, and whether you are receiving treatment for bone loss.
Someone with normal bone density and few risk factors may not need another scan for several years, while a person receiving osteoporosis treatment or taking a medication that affects bone health may require closer monitoring.
Your healthcare provider can determine whether and when repeat bone density testing is appropriate based on your individual situation.
Bone Density Test Checklist
Consider discussing a DEXA scan with your healthcare provider if any of the following apply to you:
- You are a woman age 65 or older.
- You are postmenopausal and younger than 65 with additional osteoporosis risk factors.
- You have experienced a fracture after age 50.
- You have had a fracture after a relatively minor fall or injury.
- You have a strong family history of osteoporosis or hip fractures.
- You have experienced significant or unexplained height loss.
- You have developed a noticeably stooped or curved posture.
- You take long-term corticosteroid medications such as prednisone.
- You have a condition that interferes with nutrient absorption.
- You have low body weight or have experienced significant unexplained weight loss.
- You smoke.
- You regularly consume excessive amounts of alcohol.
- You have vitamin D deficiency or other nutritional risk factors.
- You experience frequent falls.
- Your healthcare provider has identified another condition or medication that may weaken your bones.
This checklist is not a substitute for an individual medical evaluation. Some people may need bone density testing even if they do not fit these categories, while others may not need immediate testing despite having one risk factor.
Why Early Osteoporosis Screening Matters
The goal of a bone density test is not simply to obtain a number. Osteoporosis screening can identify people whose bones have weakened before a serious fracture occurs.
Hip and spinal fractures can have significant effects on mobility, independence, and quality of life, particularly in older adults. Identifying reduced bone density gives patients and healthcare providers information that can be used to evaluate fracture risk and determine whether lifestyle changes, additional testing, fall prevention strategies, or medical treatment may be appropriate.
Where to Get a Bone Density Test in El Paso
If your doctor recommends osteoporosis screening, a DEXA scan can provide important information about your bone mineral density and fracture risk. Professional Radiology offers diagnostic imaging services in El Paso, including bone density testing, to help patients and referring providers evaluate bone health.
If you are unsure whether you should have a bone density test, speak with your healthcare provider about your age, medical history, medications, previous fractures, family history, and other osteoporosis risk factors. Based on your individual risk, your provider can determine whether a DEXA scan is appropriate and how often your bone health should be monitored.
Early evaluation can be particularly important because osteoporosis may progress without noticeable symptoms. Understanding your bone density before a fracture occurs can help you and your healthcare team make informed decisions about protecting your bone health.
