Your clinician may get your bone density test results immediately, but more often than not, test results are available from 1 to 3 weeks after a test is done. You and your clinician should make a plan to discuss the results once they are available. Talking about how and when you will be informed of the results will eliminate confusion. For example, if you have normal bone density, will your clinician contact you? Or should you call for results? Some clinicians do not call if results are normal, so you need to be certain that your clinician has the right contact information and that "no news is good news." If your testing shows low bone mass or osteoporosis, will you need to have a follow-up visit with your clinician? Or does your clinician want to discuss treatment options over the phone?
To eliminate confusion and potential misunderstanding, when your tests are ordered, you should first determine if the clinician's office makes the testing appointment or if you must do that yourself. You should also ask your clinician when the results will be available after your scheduled test, how you will be contacted, whether a follow-up visit is required, and, if so, then with whom.
Some people like to have copies of their test results so that they can track their own progress, but it's not necessary to get a copy of the results of your testing. It's more important for you to know if you have osteope-nia or osteoporosis so that if you must seek medical care from other providers or if you have a fall and are taken to a hospital emergency department, you will be able to inform the new providers of your diagnosis and if you are being treated.
36. If my BMD test results are normal, when should I be screened again? If my test results show either osteopenia or osteoporosis, when should my test be repeated?
If your BMD results are normal, you should be screened again two years after the first screening, unless your risk factors change. For example, if you develop an illness requiring that you take a steroid medication, your clinician may want to reconsider the time of your next screening. Medicare currently covers bone mineral density testing every 2 years.
Because BMD tests can be quite expensive, you may not be able to afford them if you do not have insurance to cover them. Some insurance companies will pay for re-testing and monitoring based on the clinician's orders. You might be re-tested every 6 months to 1 year depending on your level of bone loss, your other illnesses or medications, and your treatment. If your BMD test results remain the same for two or more tests, the interval between re-testing could be lengthened. You should contact the member services department of your health insurance company or HMO to get information about coverage for BMD tests. Ask when you can be screened and when you can be re-tested according to their guidelines. Some clinicians don't think it's necessary to monitor BMD every year because there is not enough time to show a significant difference in bone density. Most clinicians will monitor density every two to three years for those on treatment or to demonstrate stability over time. After two or more BMD tests show that bone density is not changing, a longer interval between tests is appropriate.
When you are re-tested to monitor the progress of treatment, keep in mind that it is important to use the same machine and preferably the same person operating the machine (who can be a nurse or technician). Each machine is calibrated differently and keeping the same one gives more consistent results and measurable changes (see Question 69).
37. If my tests show osteoporosis in my hip, what is the likelihood that I have bone loss in other bones? Does osteoporosis ever affect the skull bone?
If your hip shows osteoporosis, it is likely that other bones have diminished bone density as well. If you are a white woman, your body singles out your hip—it loses one third of its bone mineral density between the ages of 20 and 80. However, other bones usually don't start to lose density until the age of menopause, or in men at a comparable age, unless you have other medical or lifestyle reasons for having osteoporosis. Approximately 4% of postmenopausal white women aged 50 to 59 have osteoporosis of the hip, and 6% of the same group have osteoporosis in the wrist. And after age 80 in postmenopausal women, osteoporosis of the hip jumps up to 52% and in the wrist to 78%! So if you are a postmenopausal woman with osteoporosis of the hip, it is very likely that you have osteoporosis of other bones, particularly the wrist.
Although you are definitely at risk for a vertebral fracture if you have been diagnosed with osteoporosis of the hip, osteoporosis of the spine is more difficult to measure because certain conditions interfere with getting accurate measurements. Measuring your spine for osteoporosis will be more difficult if you have arthritis or fractures of the spine because they interfere with the accuracy of the imaging of the spine.
More important than the fact of having osteoporosis, you will be more at risk for fracturing any bone in your body. And this includes, although rarely, your skull bone. If you have been diagnosed with osteoporosis, it
More important, you will be more at risk for frac-
in your body.
is critical that you take all necessary precautions to prevent falls (see Question 79).
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