Are there other tests that are used to diagnose osteoporosis

While other tests can be used to diagnose osteoporosis, the World Health Organization (WHO) has established the guidelines for diagnosis based only on the results of DXA testing. So most other methods for identifying osteoporosis or osteopenia are used for screening, and then if the screening test suggests reduced bone density, a DXA is ordered to make a diagnosis. The following are the other tests that are available but less widely used:

• Single energy x-ray absorptiometry (SXA), like the pDXA, is done at the wrist or the heel. Interestingly, the body part being measured for bone density is submerged in a water bath.

• Quantitative computed tomography (QCT) is a method of testing that uses CT scan technology to measure bone density in the spine. Although it provides accurate measurements, the major drawback to this test is that it exposes the patient to 50 times more radiation than the DXA test. QCT is more

Single energy x-ray absorptiometry (SXA)

Type of radiograph where the bone mineral density test is done on the wrist or heel while the body part is submerged in water.

Quantitative computed tomography (QCT)

Type of radiography that uses CT scan technology to measure the bone density in the spine.

Peripheral quantitative computed tomography (pQCT)

Type of radiography that uses the same technology as the QCT but measures bone density in the forearm or wrist; primarily used in research.

Radiographic absorptiometry (RA)

Conventional x-ray with software and scanning equipment used to measure bone density of the middle bones of the hand.

Quantitative ultrasound (QUS)

A type of radiological scan that uses sound waves to image the heel, wrist, tibia bone in the leg, and a finger for bone mass.

Radiogrammetry

A type of radiological test that, like RA, uses conventional x-rays; two hand bones (metacarpals) are used to measure and compare bone density.

expensive than DXA and takes between 10 and 20 minutes to perform. It is a good option for people who have arthritis in the spine because the QCT results are not affected by changes due to arthritis that can interfere with DXA results. Peripheral quantitative computed tomography (pQCT) uses the same technology as the QCT but measures bone density in the forearm or wrist. This test is not routinely ordered and is used primarily in the research field.

Radiographic absorptiometry (RA) is actually a conventional x-ray used to measure bone density in the hand (primarily the middle bones of the 2nd, 3rd, and 4th fingers). Special software and scanning equipment can measure bone density. Radiation from this test is minimal.

Quantitative ultrasound (QUS), like other ultrasound techniques, uses sound waves instead of radiation. The heel, wrist, tibia bone in the leg, and a finger can be imaged and evaluated for bone mass.

• Radiogrammetry is a test that, like RA, uses conventional x-rays. Instead of fingers, however, two hand bones (metacarpals) are used to measure and compare bone density.

Figure 8 shows the tests that are used to measure bone density in various parts of the skeleton.

In addition to BMD tests, there are also biochemical "markers" that are measured in blood and urine to determine if specific therapies for osteoporosis are working. Biochemical marker measurements are not used for the purpose of diagnosing osteoporosis but sometimes for monitoring the progress of treatments (see Questions 40 and 69).

Sites of Measurement

DEXA

Sites of Measurement

DEXA

QCT/pQCT

• Spine Forearm pDEXAorSXA

Figure 8 Sites in the body measured by different BMD tests. Courtesy of the National Association of Nurse Practitioners in Women's Health (NPWH).

QCT/pQCT

• Spine Forearm pDEXAorSXA

Figure 8 Sites in the body measured by different BMD tests. Courtesy of the National Association of Nurse Practitioners in Women's Health (NPWH).

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