DXA Scanning

Osteoporosis Testing-DXA

(Dual Energy X-ray Absorptiometry)

Osteoporosis is a silent disease, often (and unfortunately) discovered when a fracture occurs. Osteoporosis is not just a women's disease. Many conditions, medications or heredity can add to bone loss. If your health care provider has ordered a DXA, then the following information will help you prepare for your bone density scan. But first, we would like to introduce you to our Certified Bone Density Technologist.

JoAnn Caudill, RT (R) (M) BD, CBDT

JoAnn Caudill, RT received her radiology certification from South Baltimore General Hospital Radiology School (now Harbor Hospital Center). She is also certified in mammography. In 1996, while working in women's health imaging, JoAnn became a certified bone density technologist (DXA tech) by the International Society of Clinical Densitometry (ISCD). Currently, she is part of the ISCD faculty and has been active in their educational program development, editorial board, and as chair for the ISCD Annual Scientific meeting. She has been the lead DXA technologist in several osteoporosis drug studies. JoAnn has founded and coordinated several National Osteoporosis support groups, as well as, publishing her research in the field of bone densitometry. She has won numerous awards for her clinical expertise.

With her vast knowledge and experience in the field of bone densitometry, JoAnn is an invited speaker both nationally and internationally. She speaks to medical providers, DXA technologists, and community groups. JoAnn's experience, passion and enthusiasm in the field of osteoporosis empowers her patients to understand and to take charge of their bone health. During the scan visit, JoAnn will assess and educate each patient on calcium and Vitamin D intake, exercise for bone strengthening, falls prevention, as well as, other methods to maintain bone health and prevent fractures. Patients are encouraged to be active participants in the prevention or management of osteoporosis. JoAnn is an excellent resource.

Preparing for your DXA scan

Carroll Arthritis, LLC uses a GE Lunar Prodigy Pro bone density scanner, which is a "central" scanner, the gold standard in bone density testing. Four areas will be scanned - lumbar spine, both hips and the forearm.

To prepare for your test:

• Do not take any calcium pills the morning of your scan.
• Wear comfortable loose fitting clothing. Try to avoid metal zippers, snaps, or buttons in the abdomen and hip area. A patient gown will be provided, if needed.
• Wear easy to remove shoes, since a "barefooted" height and weight are needed as part of the bone density calculations.
• Please do not schedule any contrast studies (CT or MRI with contrast, or barium swallow) at least 2 weeks before your bone density test. The contrast can interfere with your results.
• Each patient will complete a DXA Questionnaire and a DXA Patient Instructions Form prior to the test. You may download these forms from our website.
• Unlike x-rays, mammograms, or other radiology tests, it is absolutely important to be scanned at the same facility and on the same DXA machine from year-to-year. This insures the most accurate follow-up data for monitoring a patient's progress.
• Allow 30-45 minutes for your appointment.

Reporting of results

The DXA scanner computer software will report the actual bone mineral density of each site scanned. More importantly, a T-score and a Z-score will be calculated. The T-score compares the patient to healthy normal young people of the patient's same ethnic group, whereas, the Z-score compares the patient to people of their own age, gender and ethnic group. When indicated, a FRAX score is calculated. The World Health Organization developed this tool to predict the patient's risk of fracturing in the next 10 years. The FRAX score is based on scan results, patient risk factors and medical conditions. All these variables give the health care provider valuable information to both diagnose and decide on appropriate treatments. A DXA scan report is sent to your health care provider and available on your patient portal.

PEAK BONE MASS is normal healthy bone that occurs between the of ages 20-30. Since most people did not have their bone density tested at this time, we need a baseline to compare you to.

• T-score compares the patient to Peak Bone Mass between of the spine, hip or wrist.
• Z-score compares the patient to men or women of the same age, gender and race.

These scores help the physicians to evaluate your risk of breaking (fracturing bones in the future). That is the goal of having a DXA scan; to help you prevent bone breaks that can cost you your independence!

Should you need treatment...

Treatment for osteoporosis and low bone mass (formerly called osteopenia) usually consists of adequate calcium and vitamin D intake, exercise, eliminating controllable risk factors, such as smoking, and can include a prescription for one of the osteoporosis medications (such as alendronate, Actonel, Boniva, Forteo). At Carroll Arthritis, LLC, we also administer Prolia injections and intravenous Boniva or IV Reclast in our infusion center.

The providers and staff at Carroll Arthritis, LLC are focused on prevention of osteoporosis by patient education, routine scanning and modification of risk factors. An invaluable resource is the National Osteoporosis Foundation at www.nof.org