What if I live in a rural area and I cant get to a place with a DXA machine Are there further tests that I would need

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DXA machines are the most widely available of all machines used for testing bone mineral density. However, some areas of the United States do not have access to DXA machines. Because it is important to have your bone density evaluated, particularly if you have risk factors for osteoporosis, you should still be evaluated using one of the screening tests that may be available in your area.

While it is preferable to have a test of your spine or hip to confirm a diagnosis of osteoporosis or determine if you have osteopenia, your clinician can still recommend preventive options and counsel you about nutrition and exercise for improving your bone health (see Part 3).

If you do not have access to any bone mineral density testing, it is still important to adhere to a regimen of weight-bearing exercises as well as a diet with sufficient calcium, Vitamin D, and other nutrients to maintain healthy bones. You should also make every effort to prevent falls (see Question 79).

29. If I'm x-rayed for a broken bone, will osteoporosis, if I have it, show up on the x-ray? Ifit shows up on the x-ray, would I needfurther testing?

If you have advanced osteoporosis with significant bone loss, your x-rays may show osteoporosis. It usually takes about a 30% to 40% bone loss for osteoporosis to appear on conventional x-rays. Although x-rays are not used to diagnose osteoporosis, vertebral fractures are sometimes noted on conventional x-rays of the spine. If you have a chest x-ray, for example for pneumonia, vertebral fractures might be found incidentally, meaning that you may not have complained about them but they are nonetheless present and seen on the chest x-ray. Vertebral fractures noted on any type of x-ray are usually an indication that you have some degree of bone loss; however, further testing is still required after the fracture heals.

The fact that you have fractured a bone, particularly if it was due to a small amount of force or from a standing height or less, is more important in considering whether you need further testing for osteoporosis (see Question 74). It is important to establish a baseline of

Weight-bearing exercise

Type of activity that places weight on certain bones; necessary for bone growth; examples are walking, dancing, and stair-climbing.

It usually takes about a 30% to 40% bone loss for osteoporosis to show up on conventional

bone mass so that future therapies and treatments can be monitored for their effectiveness.

Any individual who has a vertebral (a bone in the spine) fracture or hip fracture is at high risk for osteoporosis, and while the fracture should be healed first (because fractures can sometimes interfere with the accuracy of DXA testing), further bone mineral density testing is still necessary. In case you are treated for any fracture through an emergency department or through a specialist, you should always update your primary care clinician about your fracture so that further testing can take place if necessary.

Panoramic x-rays

A type of radiography, usually of teeth and surrounding bones, such as the jawbone.

Periodontal disease

Disease of the gums, tissues, and bone supporting teeth.

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