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Stress fracture - have you ever had a bone scan?

By October 29, 2008 - 9:19am
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I recently was diagnosed with a small stress fracture on the top of one of my feet. It healed relatively quickly, but because I am in menopause, my doctor wants to do a bone scan to see if I am at risk for osteoporosis.

Have you ever had a bone density test? What should I expect from such a scan? How does it work? Is there a number, as in cholesterol, that is good or bad in terms of bone strength or density?

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That is a good question. The scan was used to confirm a diagnosis but I also found out that it could have a 40% error rate for my condition. No, I do not have osteoporosis, I actually have very dense bones at this time. My numbers are all in the 1-2 plus range or on my scan up in the middle of the green areas. My scan results are charted a three color graph. Green for good, yellow for osteopenia and red for osteoporosis. I am taking calcium, magnesium and vitamin D supplements to keep them strong along with daily exercise.

One of the questions I have been asking has been about developing spots of low density and not being aware of it because you had good results from a DEXA scan of your backs and hips. No one has been able to answer the question for me. My doctor told me to ask the radiology department and radiology told me to ask my doctor.

I may ask my doctor to schedule a P-DEXA Scan in a couple years. My chronic pain condition is in my left arm and I worry about developing low density in that area. One of the problems with my condition (RSD/CRPS) is immoblization of an affected limb can creat more problems. The P-DEXA scan is a portable machine that can be used to test your extremeties, like a wrist or ankle. They are working to perfect the P-DEXA scan machine so it will give you the same information of the full body scan of your hips and spine. And, so your insurance and doctor will accept it. That would mean it could be done in the doctor's office, instead of having to go to a imagining center or hospital.


October 28, 2009 - 9:22am

I knew there was something about this topic that prompted to write. It was the question, because I thought you were asking about a different test from a bone density test. There is another test called a 3 Phase Bone Scan and it is done in Nuclear Medicine. It is a long procedure, about 3-4 hours depending on where they scan. They do a baseline scan then inject a radionuclide. You wait a couple of hours and then they scan again. They compare the pooling of the radionuclide in the 2nd scan to the 1st. I had one done 22 months ago. My scan took longer because my problem is in my left arm and your arms tend to fall off the edges of the scan, so they do additional scans of just the arms. I think the scans of my lower arms were done at the same time and took about 5 minutes. I remember the 2nd scan of my upper arm took 5 minutes of standing very still at a very odd angle, and each arm had to be done seperately. I had not eaten enough that day and I think I only made it through 4 of the 5 minutes before I got very light headed. The reason had the scan was because I have a chronic pain condition that can cause osteoporosis.


October 26, 2009 - 6:07pm
(reply to Reruho)


So interesting! Did this longer bone scan help with your chronic pain condition? Have you found that you have osteoporosis? Do you take any of the medicines said to stop or reverse bone loss?

October 28, 2009 - 8:20am

A bone density test or DEXA scan is very quick and painless procedure. It takes about 5-10 minutes. I have had 2 and I have left with the results in my hands within 15 mnutes. Aprilsnow's description is very close. My test facilty puts a foam block between my feet to hold my hips apart. You don't even have to change into a gown.


October 23, 2009 - 9:31pm
(reply to Reruho)


Thanks so much for your info. I know that women who are about to have this procedure will appreciate it. Especially the part about not having to change into a gown!!

October 26, 2009 - 8:00am

If I remember correctly, all you do is lay on a special table that they have, dressed, think you take off shoes, and then they have this machine go over you... easy as pie, just like the other response stated... like an xray. I have very bad osteoporosis! I have taken Fortaeo shots for 2 years... now I will be taking Reclast, a type of infusion, I believe. Takes a 1/2 hr. to inject, then that's it for 1 year..... will let you know how I like it!!! Prayer would be appreciated... it's on the 28th of Oct.

October 7, 2009 - 4:27pm
(reply to aprilsnow)

Thank you, Aprilsnow! I appreciate your response!

Good luck to you on Oct. 28th. I hope the Reclast is the perfect treatment for you. I wrote Oct. 28 in my calendar, I'll certainly send good thoughts your way!

October 8, 2009 - 9:33am

Wow! Awesome information!

Alysia, are you pre-menopausal or menopausal? It may be that bone density scanning isn't really done until then, because a woman still having her cycle still has the active estrogen cycle protecting her bones.

That's so interesting about the difference between ethnicities when it comes to bone density.

The stress fracture I had healed fine, but if I hadn't experienced it I'd never have believed how much something that small can hurt. I've never had a completely broken bone but it gave me all new appreciation for those who have dealt with that, if just a stress fracture in a small bone hurt like it did.

October 30, 2008 - 8:32am

Our readers also need to know:

  • The scores are based on white, postmenopausal women whose bone density is typically lower than men or other ehtnicities.
  • Osteopenia, bone mineral density that is not low enough to be classified as osteoporosis, is not a disease but is a category of low bone density scoring.
  • Not all insurance carriers cover bone density testing.
  • "Normal" is what doctors still struggle to define.
  • T-scores alone do not necessarily predict fractures.

My grandmother suffered from bone cancer. I have lupus and have had to undergo therapy that included long-term doses of prednisone. My daughter has had to undergo bone density, and bone marrow, testing just recently.

I've had stress fractures on my fifth metatarsal on my right foot and on both ankles (I'm a marathoner), but have not had to undergo bone density testing, in spite of my medical history.

More information on bone density testing can be found here.

Information on osteopenia can be found here.

October 29, 2008 - 4:56pm
HERWriter Guide

Hi Diane

Nice to read you are healing well! Was the fracture painful?

There ARE numbers your doctors will be looking for as they scan your bones. They will assess how many grams of material like minerals and calcium are in your bones and test areas like your spine, hips and wrists. We all hear of older women breaking their hips, right? They test the hips and arms because these are the areas that often break due to osteoporosis.

Your results will be scored as T Scores (your density, compared with average density of a woman your age) and Z Scores (the number of standard deviations below or above a woman of your weight, age, and ethnicity etc).

If your T Score is above 1 - all is well. If it's less than 1 and more than -2.5, your density is below normal and you'll need to take action to avoid osteoporosis. If your score is -2.5 or less, you have osteoporosis.

If your Z Score is -1.5 or less, your doctor may do further tests to make sure nothing else is wrong, aside from the normal aging process of losing bone density.

You can read tons on the Mayo Clinic site at http://www.mayoclinic.com/health/bone-density-tests/WO00024

The good news is the testing is as painless as an X Ray!

I hope this helps and that your scores are great!

October 29, 2008 - 2:32pm
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