Practice Cases
Bone Density Measurement Basics
Mary B. Laya, MD, MPH Literature reviewed July 30, 2006. Updated March 30, 2009A 66-year-old woman presents to you for an annual examination after newly moving to the area. She brings a copy of a forearm bone density report she obtained at a local drug store (see image below). The report states she has osteopenia; she is concerned but also wonders about the accuracy of the test.
She is a postmenopausal woman taking estrogen replacement therapy and atenolol for hypertension. She has no personal or family history of fracture and is a non-smoker. She weighs 158 pounds.
Click to see a larger image.
Click an answer under each question.
-
What kind of peripheral bone density testing does her report represent?
-
Which of the following statements about this type of peripheral bone density measurement is true?
- Option A Peripheral bone density readings are inaccurate in women without risk factors and should be disregarded
- Option B Peripheral bone density testing strongly predicts fracture risk at the hip and spine, and she should start on treatment based on the result.
- Option C Peripheral bone density testing results should be confirmed by another testing modality at more central sites
-
What is the best technique for measuring her bone density at this time?
-
Which of the following statements about Medicare reimbursement for bone density testing is true?
- Option A Medicare will reimburse only for bone density testing every year for women at risk for osteoporosis
- Option B Medicare will not reimburse for a confirmatory test since the patient has had one this year
- Option C Medicare will reimburse for a confirmatory test and repeat testing to monitor therapy every 2 years
-
Her confirmatory DXA shows total hip bone mineral density 0.93 SD above the 66-year-old mean and 0.36 SD below the 25-year-old mean. Which of the statements concerning her report is correct?