The Inside Story

Even people who fit into no specific risk category still can have osteoporosis and suffer fractures. One out of every 10 African-American women over 50 has the disease. Young Women—and even men—can get it.

So whether your risks for osteoporosis are high or not, finding out how strong your bones are is always a good idea. After all, osteoporosis is a preventable disease.

Bone mass measurements, also called bone mineral density tests, can determine whether you're experiencing bone loss, and at what stage. The testing is quick, noninvasive, and doesn't hurt. There are several different methods, some more revealing than others, according to David J. Sartoris, M.D., professor of radiology and director of bone densitometry at the University of California, San Diego, School of Medicine.

A standard x-ray, for instance, doesn't show evidence of osteoporosis until 30 to 40 percent of your bone mass is gone. Scans such as ultrasounds and single x-ray absorptiometries give you a snapshot of how the bone is faring in a particular part of the body, say, in the forearm or the heel.

Since the skeleton doesn't lose bone mass uniformly, says Dr. Sartoris, the only way you can truly assess early bone loss is to get a DEXA (dual-energy x-ray absorptiometry) scan. This test looks at bone density where it matters the most—in your hips and spine.

Whereas experts once waited to look closely at bone until a woman was in menopause, Dr. Sartoris believes that approach wastes 20 years or more of potential intervention. If you're a woman between the ages of 21 and 35 and are at high risk, he recommends that you ask your doctor to order a DEXA scan. Some insurance companies might not pay for this test until you're older, but Dr. Sartoris puts the #150 cost into perspective: "Women spend that much on a dress or a pair of shoes. This is a test that could mean the difference in their futures.'"

Your doctor should routinely order bone mineral density tests once you reach menopause. If you're undergoing osteoporosis treatment, you should get tested yearly.

Any time that you experience persistent back pain that doesn't go away, it could indicate a possible vertebral fracture caused by osteoporosis, and you should get an evaluation.