Many people are routinely screened for weak bones with an imaging test called a DEXA scan. If it detects osteoporosis, the results can help patients and their health professional decide how to treat the problem. But many people learn they have only mild bone loss, a condition known as osteopenia, and for them the risk of fracture is often quite low.
A bone-density test gives out a small amount of radiation, but radiation exposure can add up. A diagnosis of osteopenia often leads to treatment with such drugs as alendronate (Fosamax), which pose risks. But there is little evidence that people with osteopenia benefit from these drugs.
When to consider the test
Health professionals decide on who to refer for a DEXA scan based on risk factors such as age, a fracture from minor trauma, low body weight, and long-term use of corticosteroid drugs. Whether follow-up tests are needed depends on the results of the initial scan.
Ask these questions
Do I really need to have this test, treatment or procedure? The answer should be direct and simple. Tests should help you and your health professional decide how to treat your problem, and treatments and procedures should help you live a longer, healthier life.
What are the risks (of having or not having it)? Discuss the risks as well as the chance of inaccurate results or findings that will never cause symptoms, but may require further testing. Weigh the potential complications against possible benefits and the symptoms of the condition itself.
Are there simpler safer options? Sometimes lifestyle changes will provide all the relief you need.
What happens if I do nothing? Ask your health professional if your condition might worsen—or get better—if you don’t have the test or treatment now.
There may be tests, treatments and procedures you think you need, but you don’t. Let’s think again. Engage in a healthy conversation with your health professional today.
It’s OK to ask questions
If you have questions about your symptoms or the medicines managing your symptoms, speak with your health professional.
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© 2014 Consumers Union of United States, Inc, (101 Truman Ave, Yonkers, NY 10703-1057). Adapted from Consumer Reports (2014) and Choosing Wisely Canada (2014), Common tests, treatments and procedures you may think you need. Let’s think again. Choosing Wisely does not assume any responsibility or liability arising from any error or omission or from the use of any information in these resources.