DEXA scan preparation -
Note: it is beneficial to do this scan every months for body composition and every year if you are looking to modify something specific such as bone density. Because this test gives so much detailed information regarding various components in your body, it is a scan that can be used for anyone.
Athletes can get this scan done if they are curious to track their muscle mass as well as overall fat percentage. Due to its broad uses, the average person who is simply curious about their health could get this scan in order to gain insight regarding their body composition.
This will change based on the amount of fat there is as well as the amount of lean mass there is. Fat Mass Index FMI : The total amount of fat you have in kilograms relative to your height in meters 2.
It is a measure of how much total fat you have, relative to your size and independent of lean mass. Visceral Adipose Tissue VAT : VAT is a hormonally active component of total body fat. The measurement reflects the amount of internal abdominal fat around the organs.
This is different than subcutaneous fat, which lies beneath the skin. Increased VAT has a high correlation to cardiovascular and metabolic disease risk. Current research shows and elevated risk at around cm 2 and. It describes where the fat is stored.
Android apple shape refers to having most of the fat around the stomach and mid-section. Gynoid pear shape refers to having the fat stored around the hips. A bigger number means more android and a smaller number means more gynoid.
From a health risk standpoint, ideal values are believed to be less than 0. Fat Free Mass Index FFMI : The amount of mass that is not fat, relative to your height. This includes muscle, bone, organs and connective tissue. It can be used to gauge relative muscle mass in lean individuals.
Skeletal Muscle Mass SMM : An estimate of the total amount of skeletal muscle you have. Because muscle has approximately the same density as other organs liver, skin, etc… and other types of muscle heart, smooth muscle, etc… we are not able to directly the amount of skeletal muscle you have.
This is true of any commercially available body composition measurement bioelectrical impedance, underwater weighing. However, several scientific studies have been performed that demonstrate good accuracy between our estimated SMM and that measured by MRI or CT scanning.
Cut points in research are generally around 5. Cut points in research are generally around 0. Resting Metabolic Rate RMR : The number of calories the body needs to maintain its current mass under resting conditions.
The value provided by the DXA scan is estimated from the amounts of different tissues, and tissue specific metabolic rates. Bone Density: Shows how dense the bones are and can be used to assess the risk of osteopenia and osteoporosis.
The z-score compares your bone density to what is normal for people similar in age and body size. The t-score compares your bone density to that of a year-old. Studies have shown that bones in the right arm of a right—handed tennis player have a greater density than bones in the left arm of the same player.
This means that if you want a stronger body, you should have an exercise program that targets as many muscles and bones as possible. This is a special feature of the Exercise for Better Bones program. You get a progressive strength-training program that covers fourteen different exercises — that gradually builds over twelve weeks.
The exercises specifically target the areas most commonly affected by low bone density. Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program. But what exercises should you do and which ones should you avoid?
What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis? A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis.
After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day.
You can look at the videos at anytime and as often as you like. Enter your email address and I will start you on this free course. I do not SPAM or share your email address or any information with third parties. You can unsubscribe from my mail list at any time.
During the DEXA scan examination the technician places you in a supine position on the table part of the DEXA machine. Your knees will be flexed and shins elevated.
This position decreases the lumbar lordosis and flattens the spine against the table. The X-ray tube the generator that generates the photons is behind you and the screen that captures the photons the target that pass through your body is located in front the abdomen.
This allows the DEXA machine to measure the bone mineral density in L1 through L4 in the spine. To measure the bone density of the proximal femur in the hip area , the DEXA technician will have you abduct and internally rotate your leg.
If the leg is not adequately abducted and rotated, the bone density measurement of the femoral neck will likely not be accurate.
Like the test for BMD in the spine, the generator in the DEXA scan machine will generate the photons that will pass through your hip and pelvis area and hit the target.
The photon count will indicate the density of the bone mass in your femoral neck area. The effect is similar to sunlight passing through curtains and hitting the floor of a room. The denser the curtain and the closer the lats, the less light that passes through and shows on the floor.
In your case, the denser the bone, the fewer photons that pass through your body and arrive at the target. If you have had surgery in either of these two areas in the past, the medical professional may perform the measurement on one your forearms, also known as a Peripheral DEXA defined above.
In cases where the patient has had surgery to the back and both of the hips, the medical professional may consider acquiring a bone density test of the whole body, where applicable. This mode is also of choice for the younger population — for example, children and teens. During the bone density test procedure, you will need to lie on your back on a padded table.
You will be kept in a comfortable position until the DEXA scan is complete and you should remain as still as possible during the measurement.
You will not have to hold your breath. In most cases the facility will measure the bone density of one hip femoral neck. If your health insurer provides coverage for a measurement of the second hip, the facility will record the second hip as well.
During your visit, the staff will not only measure your bone densitometry, they will carefully measure your height without your shoes on. Height loss can be an important indicator of fractures of the spine.
As a result, height measurements should be taken each time you have a Central DEXA. A clinician measures height loss either with Historical Height Loss HHL or Prospective Height Loss PHL.
The Prospective Height Loss PHL calculates the difference between two measurements of your height taken during a period of up to three years.
In this case, the clinician has two accurate points to measure height decline. A PHL score greater than two centimetres suggests a new vertebral compression fracture.
The data is based on studies of women but can be applied to men. In this case, the clinician will use the recalled height and compare it to the current height.
An HHL greater than six centimetres for an individual over 60 and greater than four centimetres for someone under 60 suggests a new vertebral compression fracture. The duration of the Central BMD DEXA scan procedure is relatively short, however, you should allow fifteen to twenty minutes from the time you walk into the room until you leave — just to be safe.
Like most measurement technologies, the DEXA is subject to some degree of error. While they are generally accurate when it comes to measuring bone density, several factors can influence the degree of accuracy.
Osteoarthritis can affect your DEXA scan in several ways. First, if you have osteoarthritis of the spine, it will cause the cartilage to deteriorate.
This will create pits and spaces around the joint, giving it a rough texture. This rough texture can affect the photons as they pass through the spine. Second, if you have arthritis in the hip, it can reduce your range of motion and limit your ability to internally rotate your leg.
As you recall, this internal rotation is required to measure bone mineral density in the femoral neck. A compression fracture in the spine can cause the spinal body to collapse.
This will make the bone in the spine appear denser than it really is and lead to an inaccurate reading. I mentioned earlier in the post that the technician will ask you to move into various positions when you are on the examination table.
You will also have to flex your knees and flatten your back. Some people can find these movements a challenge. This is especially the case for older individuals who are less mobile than they were in the past.
Obesity can be a challenge for the DEXA equipment. First, the extra size can block the photons as they pass through the body and affect the score. Second, some manufacturers limit the size of the people who can take the test. One manufacturer has a weight restriction of pounds. It can be a challenge to get consistent bone mineral density scores for people who are thin.
A Densitometry Technologist indicated to me that they can get three different scores when they take a DEXA scan of a thin person. A thin person likely has porous bones and this can cause the distribution pattern of the photons to vary each time the scan is executed.
A technologist who is capable and careful will yield more accurate and dependable DEXA scan results compared to a poorly trained technician.
Make sure your Technologist is accredited through a recognized body. DEXA technology is quite complex and the quality of machines can vary. DEXA experts we have spoken with recommend machines from GE Prodigy and Norland. Another important factor that influences the measurement of the machine is the frequency and maintenance of the equipment.
One of the leading medical imaging institutions I spoke to in Ontario indicated that they calibrate and test their DEXA machines every working day for accuracy.
In addition, they indicated that while their DEXA machines were 10 years old, they replaced the primary components every 3 to 5 years. These upgrades and replacements have improved accuracy and reduced radiation levels in their DEXA machines.
The components that they change out include the tube, filter, target and the generator. In many jurisdictions, including the United States and Canada, women over the age of 65 and men over the age of 70 are encouraged to have a DEXA scan for preventative screening purposes.
After the initial DEXA scan, individuals in this group are encouraged to have an examination every twenty four months. In the United States, Medicare will cover the cost of a DEXA scan for women 65 or older and men who are 70 and older.
If you are a woman under the age of 65, you should consider a DEXA scan if the following applies to you:. It is a good idea to have a baseline DEXA scan as you enter menopause. The results of this examination will give you an accurate record of the change of your bone density as you progress through menopause.
It can also motivate you to maintain or even improve your bone density through exercise and nutrition, thereby reducing the chance that you will have take a pharmaceutical like Prolia, Fosamax or Forteo later in life.
Once you have the baseline DEXA, there is no need to have another test for a number of years unless the baseline test identifies that you have low bone mass. A baseline DEXA scan is appropriate for most men. Bone density can decline at a more rapid rate during andropause when compared to menopause.
After reading this post in June of , my husband Richard, asked his physician to prescribe a baseline DEXA to measure his bone mineral density.
Fortunately, Richard has an enlightened physician who supports the DEXA test for men and encouraged him to establish his baseline score. Several weeks after receiving the prescription, Richard visited an imaging centre in Ottawa and completed the test.
The intake process and procedure was similar to that described in this post. When he was setting up the appointment, the organizer made it clear that he should not take calcium supplements before the test and should wear clothing that did not have metal.
When Richard arrived for the procedure he had to complete a short intake form. It asked him if he had a history of fractures, took steroids in the past, and other relevant questions.
The intake form was handed to the Radiology Technologist. When she reviewed his form, she was surprised that he was taking the test at this time.
He had no history of fracture and, according to guidelines she followed, he was too young to take the test. When Richard pointed out that he wanted a baseline score and that his mother and sister had osteoporosis, the Technologist was dismissive.
She begrudgingly administered the test and followed the procedures described in this post and Richard got what he wanted — a baseline score. It is good to monitor your health and a baseline DEXA score is a step in that direction. Unfortunately, you might meet some resistance but I encourage you to press forward and manage your bone health proactively.
A study published in March, in The Spine Journal, Rates of osteoporosis screening and treatment following vertebral fracture , showed that, in some jurisdictions, that not enough people are getting DEXA scans.
Between and , 2, unique patients visited emergency department for one or more vertebral fractures. The patients were 50 years and older. According to one of the co-authors, Jonathan J. Carmouche, M. Some of these patients probably fell through the cracks because they were under the age of 65, some might have been overlooked because their health care plans did not provide adequate screening coverage.
However, it seems as though we should be more aggressive with this screening in order to get in front of vertebral and hip fractures. The DEXA scan examination is very safe. Additionally, a Vertebral Fracture Assessment VFA can be done at the same time and location as measurement of BMD by DEXA.
How often you get a DEXA scan depends on a number of variables including your age and changes in health. The recommendations can vary across jurisdictions. As I mentioned earlier, Medicare will provide a DEXA scan every twenty four months for women after the age of In the past two years I have noticed more information being provided in DEXA reports.
One of the more common new features is something referred to as TBS. TBS is an abbreviation for Trabecular Bone Score. As mentioned in past articles, bone density is only part of the equation that relates to bone strength.
The other part is the quality of the bone. When it comes to research studies, bone quality is assessed with tools such as a QCT, Quantitative Computer Tomography. Due to the high levels of radiation exposure, the few number of machines available, and the cost of the examination, few individuals outside of research studies will ever be referred for a QCT.
The makers of DEXA machines have attempted to provide physicians with more insight into the quality of the bone through a measurement they call TBS. The TBS score is derived from the grey-level texture measurement of the lumbar spine DEXA.
Whereas a low TBS score indicates the opposite, more trabecular separation, fewer trabecula and therefore a higher risk of vertebral spinal compression fracture. Although not widely used within existing DEXA machines, studies have shown a correlation between low lumbar spine TBS with the incidence of an old and new fracture.
The following are some important guidelines for your DEXA bone scan preparation. Read these to prepare for a DEXA scan procedure. On the day of your scheduled Central DEXA BMD bone density test examination and as part of your bone density test preparation, you should follow these patient preparation guidelines:.
You can eat your regular meals the day of the DEXA scan examination, however, you should not take calcium supplements at least 24 hours in advance of the scan. In most cases you will not have to undress for a bone density test.
The staff and clinician will make every effort to keep you in your own clothes during the examination. However, the staff may ask you to wear a gown.
Depending on the test center, the staff might request that you remove items that interfere with the DEXA scan including:. Patients often visit me because of a decline in their DEXA score. The reasons for the decline vary from individual to individual.
The reasons for the change in scores include their unique genetic makeup, lifestyle, exercise habits, diet and medical history. The appropriate response to the decline can vary, as well. You should always discuss the right strategy with your physician. Your response can include a combination of changes to your:.
Depending on the degree of change, pharmaceutical intervention may be required to reduce fracture risk. The correct response to the DEXA score decline for you depends on your medical history and the risk of fracture. It is important that you consult with qualified health professionals who can help you make the right decision for you.
Susan not her real name called me after a recent move from Virginia to Utah because she was concerned about the decline in her DEXA scan test results.
Her DEXA scans were only taken 14 months apart. With she moved across the country, she changed health care providers and doctors. Her new doctor requested a fresh DEXA test. When I met with Susan she mentioned her surprise in the loss of BMD in just over a year. Before discussing her exercise regime and how she could better address bone loss, I took a look at her BMD DEXA scores.
Different manufactures produce very different DEXA machines. Their results should not be be compared. Even machines produced from the same company will not be perfectly identical. When I read that Susan had moved across the country, I requested all of her DEXA results to ensure that the appropriate intensity of exercise was prescribed.
Both locations used machines from the same manufacturer, which made me more comfortable to put some weight in comparing results. Many reports only provide the BMD of one hip. This was the case for her first DEXA scan in Virginia where they only had a reading for her left hip.
In Utah, she had a BMD of both hips but the report only reported on the right. Her right hip BMD was significantly lower than the left hip BMD. However, when you compared the BMD of her left hip from year to year it was unchanged. DEXA measurements of the spine are usually taken of the top four lumbar vertebra, L1, L2, L3, L4.
The scores of all each vertebra was recorded in both locations. In the east coast, they took the average of all four L1 — L4 measurements. In Utah, they only took the average of her top two vertebra, L1 and L2, they had the weakest scores.
By only using the average of her two weakest scores and not averaging the reading over all four vertebra, it appeared that she had lost significantly more bone. Some of the newer DEXA centres have apps that allow them to get views of the spine from the upper thoracic area just bellow the shoulders to the low back.
Fortunately, Susan sent me the entire report. Well into the report there was a very noticeable Stage 2 compression fracture. The radiologist had noted it but her physician had failed to tell her about it.
When I asked her if she had a past episode of back pain or a fall she did recall a severe episode shortly after her move. In fact she did not have a fall. During the move she unpacked a lot of boxes and helped her husband with yard work. The pain lasted 6 to 8 weeks. Because she had relief with Physical Therapy, she forgot to mention it in her intake.
From my point of view her vertebral compression was a game changer. We now had information on the quality of her bone. When comparing DEXA reports be sure you compare apples to apples. Right hip to right or left hip to left.
Several studies have looked at the differences between BMD of the right and left femoral neck hip in postmenopausal women. Check the size and appearance of the boxes. If the medical imaging institution that you have your DEXA done does not have an app that looks at a bigger picture of your spine then you have to be your own advocate.
The most common fracture sites in the osteoporotic spine is in the thoracic spine, just around your bra strap. For men, this is just below the bottom of your shoulder blades.
DEXA reports never capture the thoracic spine for BMD recording because of the interference of our ribs and breast bone. However, if you have height loss or you have had sudden onset of back pain that persisted for over 4 weeks then the possible source could be a compression fracture of your vertebra.
Robert Hakim generously contributed to this article. He wrote the section dedicated to how to prepare for your DEXA exam. Robert M. Hakim M. Robert is a Member of the International Society of Clinical Densitometry. For more information, check out my Osteoporosis Guidelines.
I was told that it is important to always have your BMD test done using the same machine in the same clinic if possible. Fortunately, Riverside Hospital got a new one a few years ago and it will outlive me. Also, the term 'borderline' was used to describe someone who had declining BMD and who might want to soon take some measures to improve your BMD.
I went from normal to borderline and back to normal but when I asked how that could be, I was told they changed the definition of borderline a few years ago so my BMD hadn't really improved, they just changed the definition so I was normal after being borderline.
Been waiting for a long time for a comprehensive article on the aspects of DEXA and osteoporosis. Thank you so much!!!!???? Hi Jennifer. Thank you for your comment and for following us. We are thrilled to hear that you like the DEXA guide.
Thank you for the excellent and comprehensive article. Since I had a Bone Density 18 months ago and will be due in May, I do not recall anyone informing me to hold my Calcium intake for 24 hours or did they measure my height and compare that measurement during the years or did anyone determine the trabicular bone score.
When is a FRAX done? Who would be the person to request that all these measures be performed? Hi Susan: Your physician or other health provider would use the FRAX.
Margaret wrote a comprehensive post on the FRAX. Hi Darla. Thanks for pointing that out. We are aware of that but decided to stay with "DEXA" for the article because people still use that when they search on the internet. I had thrown out heavy gardening pots etc. involving a twist into a skip, my GP in The Netherlands suspected only muscle pain.
Now I realize my osteoporosis is worse than 5 years ago but the results comparatively suspect. Not wanting to go onto bisphosphonates for various reasons I am sticking to my physiotherapist who I have shown your Exercises for Bones Book and with which I am very happy with. I have also purchased your video programme for better posture in 30 days but I guess there I have to be critical what exercises to undertake.
My SI joints t are now the issue regarding pain. Any tips more than welcome. Your manner of presentation is great.
I would be knocking on your door if Canada was not so far from The Netherlands. Hi Elizabeth, Thank you very much for bravely sharing your story. I apologize for the delay in responding to you. I am glad you are working with a local physiotherapist, she can fine-tune the exercises based on your current situation.
All the exercises in the Perfect Posture course are safe for you to do. The exercises that are demonstrated from the floor can also be done from a firm bed. Wishing you all the best for a strong recovery. If you ever visit Ottawa please drop me a line.
Warmly, Margaret. Many thanks for your reply.
A DEXA scan is Amazon School Essentials high-precision type Caffeine and energy drinks X-ray that measures your bone mineral density and bone loss. Preparatlon your scaan density is lower than normal Amazon School Essentials your age, it indicates a risk for osteoporosis and bone fractures. DEXA stands for dual energy X-ray absorptiometry. This technique was introduced for commercial use in It sends two X-ray beams at different peak energy frequencies to the target bones. One peak is absorbed by soft tissue and the other by bone.DEXA scan preparation -
It is also important to not take calcium supplements 24 hours prior to your test to ensure accurate bone density readings. Upon arriving at our medical office you will be greeted and taken back to meet with the licensed technologist who will perform your scan for you.
After measuring your height and weight, you will be asked to lie down and get comfortable and the scan will begin. The scan takes 6 minutes. Once the scan is over you will be able to sit down with the exercise specialist to go over your results.
Your results will be explained to you and suggestions will be given according to goals that you have i. You will be able to keep your packet of results as a reference in the case that a follow up is desired in the future.
Note: it is beneficial to do this scan every months for body composition and every year if you are looking to modify something specific such as bone density. Because this test gives so much detailed information regarding various components in your body, it is a scan that can be used for anyone.
Athletes can get this scan done if they are curious to track their muscle mass as well as overall fat percentage. Due to its broad uses, the average person who is simply curious about their health could get this scan in order to gain insight regarding their body composition.
This will change based on the amount of fat there is as well as the amount of lean mass there is. Fat Mass Index FMI : The total amount of fat you have in kilograms relative to your height in meters 2.
It is a measure of how much total fat you have, relative to your size and independent of lean mass. Visceral Adipose Tissue VAT : VAT is a hormonally active component of total body fat.
The measurement reflects the amount of internal abdominal fat around the organs. This is different than subcutaneous fat, which lies beneath the skin. Increased VAT has a high correlation to cardiovascular and metabolic disease risk.
Current research shows and elevated risk at around cm 2 and. It describes where the fat is stored. Android apple shape refers to having most of the fat around the stomach and mid-section. Gynoid pear shape refers to having the fat stored around the hips. A bigger number means more android and a smaller number means more gynoid.
From a health risk standpoint, ideal values are believed to be less than 0. Fat Free Mass Index FFMI : The amount of mass that is not fat, relative to your height.
This includes muscle, bone, organs and connective tissue. It can be used to gauge relative muscle mass in lean individuals. Skeletal Muscle Mass SMM : An estimate of the total amount of skeletal muscle you have.
Because muscle has approximately the same density as other organs liver, skin, etc… and other types of muscle heart, smooth muscle, etc… we are not able to directly the amount of skeletal muscle you have. This is true of any commercially available body composition measurement bioelectrical impedance, underwater weighing.
However, several scientific studies have been performed that demonstrate good accuracy between our estimated SMM and that measured by MRI or CT scanning. But the risk associated with any one scan is very small. Scans and other x-rays are strictly monitored and controlled to make sure they use the least possible amount of radiation.
The benefits of having a bone density scan outweigh the risk of exposure to the small amount of radiation received during the scan.
A bone density scan tells your doctor how strong your bones are by using a numbered score. Your doctor will use this score to discuss whether you have normal bone mass, low bone mass or osteoporosis. A bone density scan can also predict how likely you are to break a bone over the next 10 years by using a percentage.
Your doctor will use this percentage to discuss if you have a low, moderate or high risk. Your doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.
Preparing children before a test or procedure can help lower their anxiety, increase their cooperation and develop their coping skills. This includes explaining to children what will happen during the test, such as what they will see, feel and hear. Preparing a child for a bone density scan depends on the age and experience of the child.
Find out more about helping your child cope with tests and treatments. The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.
We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.
The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on cancer. ca, nor do we endorse any service, product, treatment or therapy. Home Treatments Tests and procedures Bone density scan Print.
Bone density scan. label }} In Bone density scan {{ target. label }}. Why a bone density scan is done. How a bone density scan is done. You can eat normally but should not take calcium supplements for 24 hours before the test. Side effects. What the results mean. What happens if the results are abnormal.
Special considerations for children. References American Society of Clinical Oncology. British Columbia Ministry of Health. Bone Density. Bone Health. Fischbach FT, Fischbach MA.
A bone density scan is Amazon School Essentials imaging ecan that uses x-rays xcan measure how strong DEXA scan preparation bones are. Dcan is also called a bone densitometry or dual energy x-ray absorptiometry DEXA scan preparation scan. A bone density Foods that boost metabolism may be done Scab measure the amount of minerals, such Bod Pod body composition analysis calcium, in bone assess your risk of pre;aration a bone check for bone loss diagnose osteoporosis. A bone density scan is usually done as an outpatient procedure in the x-ray radiology department of a hospital or clinic. The test can take 5 to 20 minutes, depending on the number of areas being scanned, but it may take longer. Before you have a bone density scan, it is important to tell the x-ray technologist or radiologist if you are breastfeeding or pregnant or think you may be pregnant. It is also important to tell the x-ray technologist or radiologist if you recently had a barium examination or have been injected with a contrast medium for another test.
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