Bone Density Test -what parts of the skeleton is scanned?

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dogsandjogs
dogsandjogs Member Posts: 1,907

I have had three bone density tests and they scanned the hips and the spine. Now my friend in Seattle tells me her scan showed osteopenia in her ARM! How could that be?

Are any of you aware of any bone density tests that scan arms?   

I have wondered why they don't scan the whole skeleton. Does anyone know?

Comments

  • DiDel
    DiDel Member Posts: 1,329
    edited April 2012

    I had a Dexa scan that scanned my whole body...well except my head..i think. It was the easiest most relaxing scan I have had.

    Diane

  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited April 2012

    You did? I wonder why I wasn't given that option----

  • ALittleBitBritish
    ALittleBitBritish Member Posts: 627
    edited April 2012

    I have annual dexascan, they measure my arms, hips and spine.



    To date I have low bone density in my spine which I have had for a few years.



  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited April 2012

    Well, maybe it is better not to know. My spine and left hip is really bad. The right hip broke 3 years ago and since I had the hip-pinning surgery they can't scan it.  But the left hip is "in danger of fracture" according to the report.  This is one of the reasons I quit taking Aromasin.

    I have talked about his on another thread. The doc feels that my osteoporosis was caused by an un-diagnosed parathyroid tumor (since removed)   Everyone was shocked, including me, when I had the first bone density test since I've been a runner (now a jogger) for 30 years so should have really strong bones. But I broke my arm in the early eighties, have broken a toe and a finger, a wrist 4 years ago and then the hip!  It is true I'm very active and most of these breaks happened while running - but still ----so the consensus of opinion is that the parathyroid tumor caused it.

  • otter
    otter Member Posts: 6,099
    edited April 2012

    dogsandjogs, it's been my understanding that the "gold standard" for bone density scans is the DEXA scan.  "DEXA" is a brand name, though, so there might be other versions.

    I also thought the DEXA scan typically included the lower spine (lumbar vertebrae) and one or the other of our hip joints (upper femur).  I didn't know DEXA scans could include our arms.  How does that work?

    I've heard of some women who had "bone density scans" with simple in-office machines, rather than the bigger DEXA machine.  Those small in-office machines scan wrists or sometimes heel bones.  The machines are cheaper and the scans are simpler, but I don't know if they're as accurate or the results as reproducible as with the DEXA machines.

    otter

  • snorkeler
    snorkeler Member Posts: 145
    edited April 2012

    I was told that the spine and hips are scanned because they are representative of the two types of bones we have (compact and spongy). But since it seems that each bone in our bodies could have a different density, I think the scan results are meant to give a general idea of fracture potential.

    The technician also explained that since DEXA machines are large (and I'm sure very expensive), the smaller machines that measure the wrist and heel are often used in mobile clinics and other places that don't have DEXA machines.

  • peggy_j
    peggy_j Member Posts: 1,700
    edited April 2012

    Interesting. I'm curious to know if the wrist and ankle are good representations of overall BMD. Does anyone know? In my case, my spine was slightly above average and my hip slight below average; I've been told it's not unusual for them to be different like that (everyone's anatomy is different) so I wonder how these other bones compare. 

    I noticed the FRAX tool asks for the Femoral Neck BMD.  So even if the wrist is a good indication I wonder if there's much data to show the correlation to fracture risk. (???)

    FWIW, DEXA isn't a brand name, it's an acronym

    http://en.wikipedia.org/wiki/Dual-energy_X-ray_absorptiometry

    FRAX lists several companies that make the machines. 

    http://www.shef.ac.uk/FRAX/tool.jsp 

  • crabbiepattie
    crabbiepattie Member Posts: 108
    edited April 2012

    My DEXAs, taken over the past 5 years or so, have been of spine, one hip and one forearm.

  • ohio4me
    ohio4me Member Posts: 491
    edited April 2012

    There are three ways to test bone density - via Nuclear Medicine (rarely done), CT (somewhat used), and DEXA (commonly used. DEXA is Dual Energy Xray Absopitometry. The common areas to scan are the hip and the spine as they are weight bearing and the most common areas to detect early bone loss. It is not uncommon to also test the arm - it can be included in routine testing.

     Okay - so radiology is my profession and I have performed many DEXA scans.  Nice thing - painless exam and low radiation.

    Hope this is helpful.

  • Outfield
    Outfield Member Posts: 1,109
    edited April 2012

    The usual DXA scan evaluates the femur part of the hip and the lumbar spine.  It doesn't scan the whole body.  We don't do forearms where I am - I don't know of data whether measuring that adds to the ability to predict fracture risk.  Any DXA is not perfect for that, but there is no assessment that is perfect.

    The spine is commonly misleading because if there's any arthritis which has caused bone spurs, those spurs can cause the results to be falsely elevated.  

  • Kicks
    Kicks Member Posts: 4,131
    edited April 2012

    I've been having bone density tests for more than 10 years because of family HX. They have always been x-rays of hips and lower spine. According to what I've been told the hip area is the first to show problems. Wrists or ankles never x-rayed.

  • HealingDreams
    HealingDreams Member Posts: 50
    edited June 2012

    Thanks to ohio4me and Outfield for insider information!

    My left arm, as well as my hips and spine, have been DEXA'ed for the last two years. I am not sure why, perhaps because I have osteoporosis of the spine and osteopenia of -- of all things!--the femur.

    I'm starting on anastrozole, aka arimidex, soon, now that my oncotype score is back. I have been off alendronate, aka fosamax, for a few months, and my PCP wanted a new baseline. Thus, another DEXA after only one year instead of the typical two.

  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited June 2012

    I quit taking Fosamax due to the possible SE of a femur fracture (which I had just after starting the drug so probably not related, but even so, they now say Fosamax can cause this.)

    I also got 3 spinal fractures 1 1/2 years ago. 

    I also started having jaw pain - my pharmacist agreed it was probably better to quit the drug.

    Just after that, I read that Fosamax works by building bone on the SURFACE of your bones which only make them more brittle and therefore in danger of fracture. Bone building occurs inside your bones so adding bone to the surface doesn't really help.

    Has anyone else heard this?

  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited June 2012

    dogsandjogs - I heard the same thing - that the "bone building"drugs really create a harder exoskeleton around an already porous interior bone structure....

    Then you step off the curb and your femur breaks.....

    My MO wants me to take the bone-building drugs when I start the Arimidex in the fall. My answer will be no.

    I recently started weight and resistance training to strengthen my already compromised (osteopenia) bones.

  • dogsandjogs
    dogsandjogs Member Posts: 1,907
    edited June 2012

    Blessings:  I too exercise and weight lift. Used to run marathons; now just jog every day with my dogs and also 3 or 4 times a week by myself. I recently had some ligament damage so am not jogging. Instead, I joined a very intense exercise class where we power-walk with weights, do stairs and curbs, core work and all kinds of other exercises which really get your heart rate up. The trainer is a black belt and she takes no prisoners LOL. I'm going to a class in 45 minutes - can't wait!

  • coraleliz
    coraleliz Member Posts: 1,523
    edited August 2012

    Bumping this because I just had my scan today. I was told that my lower back would be scanned & my hip. If those readings were low, my wrist would also be scanned. The tech didn't scan my wrist. So, I guess that means my bones are healthier than I thought? I figured I'd come back osteopenic. Have read that "petite" (always hated that word)women have lower scores than "regular" size women. Also have a family history or osteoporosis & osteopenia(premenopausal).

    The PA at my MOs office thought I should be taking calcium & that is what ultimately lead to me getting this scan

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