Bone density

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Bone density is a medical term referring to the amount of matter per cubic centimeter of bones. It is measured by a procedure called densitometry, often performed in the radiology or nuclear medicine departments of hospitals or clinics. The measurement is painless and non-invasive and involves minimal radiation exposure. Measurements are most commonly made over the lumbar spine and over the upper part of the hip. The forearm is scanned if either the hip or the lumbar spine can't be.


The most common reason for measuring bone density is to screen for, or diagnose, osteoporosis.


Results are often reported in 3 terms:

  1. Measured density in g/cm3
  2. Z-score, the number of standard deviations above or below the mean for the patient's age and sex
  3. T-score, the number of standard deviations above or below the mean for a healthy 30 year old adult of the same sex as the patient


The technique has several limitations.

  1. Measurement can be affected by the size of the patient, the thickness of tissue overlying the bone, and other factors extraneous to the bones.
  2. Bone density is a proxy measurement for bone strength, which is the resistance to fracture and the truly significant characteristic. Although the two are usually related, there are some circumstances in which bone density is a poorer indicator of bone strength.
  3. Reference standards for some populations (e.g., children) are unavailable for many of the methods used.
  4. Crushed vertebrae can result in falsely high bone density so must be excluded from analysis.

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