Bone Density Scan (cont.)
What is the cost of DEXA?
The cost for DEXA scanning varies
depending on insurance policies and coverage. In general, a patient without coverage paying cash can expect to pay
approximately $200 U.S. for the procedure.
What about the accuracy of BMD
testing in the doctor's office using smaller equipment?
There are several devices that are smaller than the standard DEXA scanners that are being used in doctors offices to screen for low bone density. Very little scientific data is available about these smaller units. Most of the information comes directly from the equipment manufacturers themselves. Many of these models test peripheral bones in the feet or hands. Other units use ultrasonography. These techniques can be less accurate than BMD testing performed with state of the art equipment. Additionally, office-testing equipment can range dramatically in price and quality.
In general, these devices may be reasonable to measure overall fracture risk but are not useful in monitoring therapy. Their use might be limited to screening and results would require confirmation using
DEXA. In addition, expertise in using the equipment and interpreting the data can vary. At present, it is difficult to comment on these other methods of BMD testing. Some doctors use these as screening tools and recommend more formal DEXA testing if they are abnormal.
Summary
Osteoporosis is a disease that results in a significant risk of fracture. The consequences of fracture can include hospitalization, immobility, a decrease in the quality of life, and even death. From a larger perspective, it is a costly disease in terms of the health-care system and time lost from work. Early detection and therapy is the mainstay for trying to prevent these complications. BMD testing results correlate well with the risk of fracture, and the testing is easily performed in a time-efficient manner without any discomfort. Although many methods of BMD testing exist, the best currently is DEXA scanning. It is imperative that testing ultimately be done using state-of-the-art equipment with capable highly-trained personnel and a doctor well versed in interpreting the results.
- 40% of postmenopausal women in the U.S. have osteopenia (low bone density).
An additional 7% have osteoporosis.
- In 1995, osteoporosis-related fractures were
associated with over 400,000 hospitalizations, stressing the importance of early detection and
appropriate prescription therapy.
- Bone mineral density (BMD) estimates the true mass of
bone.
- BMD analysis is recommended for women between ages 50 and 65 with risk factors for osteoporosis and for all women over the age of 65. In addition, men and women taking certain medications or having certain diseases should discuss testing with their doctor.
- By measuring BMD, it is possible to predict fracture risk in the same
manner that measuring blood pressure can help predict the risk of stroke.
- DEXA is quick, painless
and the preferred method to measure BMD.
- Osteoporosis has many available prescription and
nonprescription treatment options once the diagnosis is made.
Previous contributing author: Medical Revising Author: Carolyn J. Crandall, MD, FACP
References:
Cummings, et al. Am J Med 2002.
Gelbach, et al. Osteoporosis
International 2003.
Marshall, et al. BMJ 1996.
National Osteoporosis Foundation Physician's Guide to Prevention and Treatment of Osteoporosis 2003.
Sarkar, et al. JBMR 2001.
Siris, et al. JAMA 2001.
Watts, et al. J Clin Densitom 2004.
Last Editorial Review: 4/11/2008
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