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When it comes to osteoporosis and bone health, getting a picture is an important step to fully understanding a patient’s condition and giving an accurate diagnosis. For many years the gold standard for assessing bone quality and diagnosing osteoporosis has been a DXA (dual x-ray absorptiometry) test. A DXA test helps identify bone strength and density, the results generated are called a BMD score or Bone Mineral Density score. Bone mineral density is important in determining bone health because denser bone mass is a signifier of strength in bones. A BMD score will classify you into one of several groups that relate to a diagnosis of osteoporosis, osteopenia, or normal bone density.

A DXA scan is a quick and painless examination that should take only about 15 minutes. The only preparation you need to do for a DXA test is ensure that you are not wearing clothing with any buttons, zippers, or metal around the waist or hips or across the chest. When your DXA has begun, all you will do is lie back and wait for the scan to complete.

If your provider suspects that you may be at a higher risk for osteoporosis or bone loss due to a low BMD or because of age, previous fragility fractures, long term steroid use, diabetes, or being post-menopausal there may be other tests or methods they use to help them diagnose and accurately treat you.

In 2012 a new technology was approved that shows bone quality. This new technology is called TBS which stands for Trabecular Bone Score and can be combined with a traditional DXA exam. The name comes from the part of some bones in the body also known at trabecular bone, cancellous bone or spongey bone. Using TBS technology, your provider can get a picture of the micro-structure of your bone which shows a more accurate image of the bone quality. The better the structure in your bones, the less likely you are to have a fracture.

TBS has been shown to be a much better predictor of fracture risk than a DXA scan alone when there are other considerations about bone strength, like arthritis of the spine which can cause a higher BMD when looked at through a DXA exam because of the compression in the spine. Using TBS even patients with arthritis in the spine will be given a better picture of the strength in their bone structure. With a better understanding and a more comprehensive picture of bone health from TBS, your provider will be able to better optimize your treatment or non-treatment of bone loss and osteoporosis.

The main reason we treat osteoporosis is to prevent fractures. Using TBS and many other tools for diagnosing osteoporosis, our osteoporosis experts can help prevent expensive fractures.