What a Bone Density Test Can Tell You About Your Fracture Risk

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Your Health Magazine Contributor

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What a Bone Density Test Can Tell You About Your Fracture Risk

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Bone loss is quiet. It does not hurt, it does not show up in the mirror and, for many people, the first sign that something is wrong is a broken wrist or hip after a minor fall. By then, years of gradual thinning may already have taken place.

A bone mineral density test is one of the simplest ways to find out where your bones stand before a fracture happens. The scan is quick and painless, and the results give you and your health care provider a clearer picture of your fracture risk and what, if anything, needs to change. Here is what the test measures, who should ask about it and what to expect on the day.

Why Low Bone Density Often Goes Unnoticed

Osteoporosis develops when bone is lost faster than it is rebuilt, leaving bones thinner and more likely to break. Because the process causes no symptoms on its own, many people do not know they have it.

The Public Health Agency of Canada reports that almost 2.5 million Canadians aged 40 and older are living with diagnosed osteoporosis, and that about 81 per cent of them are women. The agency also notes that people are often unaware they have the condition until a fracture occurs, with hip fractures among the most serious.

A bone density test closes that gap. Instead of waiting for a fracture to reveal weak bones, the scan measures bone mineral density directly, so low bone mass can be identified and managed earlier.

Who Should Ask About a Bone Density Test

Age and fracture risk are important factors in deciding when bone density testing is appropriate. Osteoporosis Canada recommends screening beginning at age 70 for people without additional risk factors. Testing may be appropriate earlier for people with risk factors, including those ages 65 to 69 with one clinical risk factor and those ages 50 to 64 with a previous osteoporosis-related fracture or multiple risk factors. Other factors can raise the risk at any age, and they are worth raising with your doctor or nurse practitioner:

• A previous fracture from a minor fall or bump.
• A parent who broke a hip.
• Long-term use of medications such as corticosteroids.
• Early menopause or conditions that affect hormone levels.
• Low body weight, smoking or heavy alcohol use.

Why the Test Matters Most After a Fracture

A fracture from a minor fall is one of the clearest signals that bones may be weaker than they should be, yet many people never receive follow-up care. The Public Health Agency of Canada’s report on the osteoporosis care gap found that most Canadians who had an osteoporosis-related fracture did not receive adequate osteoporosis management in the year that followed, and it describes that year of screening and treatment as critical in preventing future fractures.

If you have broken a bone from a fall at standing height or less, asking whether a bone density test is appropriate is a practical first step toward closing that gap.

What Happens During a Bone Density Scan

Most bone density tests use dual-energy X-ray absorptiometry, often called a DXA or DEXA scan. You lie on a padded table while a scanner arm passes over your hips and lower spine, the areas most commonly measured. The scan uses a low dose of X-ray, takes only a few minutes and is painless.

Preparation is simple. Wear comfortable clothing without metal zippers or buttons, and follow any instructions from the clinic about calcium supplements, which you may be asked to skip on the day of the test. Let the technologist know if you are or might be pregnant, or if you recently had a test that used contrast material.

For adults 50 and older, results are commonly reported as a T-score, which compares bone density with that of a healthy young adult. Younger adults may instead be assessed using a Z-score, which compares bone density with others of a similar age. Your health care provider will interpret the results alongside other risk factors to assess fracture risk and decide whether treatment, lifestyle changes or repeat testing makes sense.

Booking a Bone Density Test

In Ontario, a bone density test requires a requisition from a doctor or nurse practitioner, and how often OHIP will cover a repeat test depends on your risk level. Your provider can tell you whether you are due.

For patients in the Hamilton area, AlfaScan.ca offers bone mineral density exams by appointment at its Hamilton and Caledonia clinics, alongside X-ray and ultrasound services. The clinics are accredited through Accreditation Canada’s Integrated Community Health Services Centres program, and patients can view their images and reports online through PocketHealth.

Frequently Asked Questions

Does a Bone Density Test Hurt?

No. You lie still on a padded table while the scanner passes over you, and most scans are finished within a few minutes.

How Much Radiation Is Involved?

A bone density scan uses a low dose of X-ray. Your provider orders it when the information it provides about fracture risk outweighs that small exposure.

What Does a T-Score Mean?

A T-score compares your bone density with that of a healthy young adult. Lower scores point to lower bone density, and your provider will interpret the number alongside your age, history and other risk factors.

Do I Need a Referral for a Bone Density Test in Ontario?

Yes. You will need a requisition from a doctor or nurse practitioner, and the clinic will book your appointment once it has been received.