Osteoporosis Screening: When Not to Get a Heel Scan

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Heel ultrasound scans can be a quick and easy screening tool to measure bone density. Heel scans are often used at community-based screening programs because of the portability of the equipment.

Studies have shown that heel ultrasound scans can help identify people at high risk for hip and other fractures. Like the hip and vertebrae, the heel contains a high proportion of trabecular bone, the spongy type that is more susceptible to thinning.

Nevertheless, DXA (dual-energy X-ray absorptiometry, a special X-ray) of the hip and lumbar spine, remains the “best predictor” of fracture risk, according to the National Osteoporosis Foundation. In fact, starting at age 65, women should skip heel scans and go right to DXA testing, as should men over 70 and younger people who are at high risk for osteoporosis.

Both heel scans and DXA may predict fractures even better when the results are combined with an evaluation of other known osteoporosis risk factors, such as your age and body mass index, your history of fractures and falls, and whether you smoke.

Keep in mind that if you have an abnormal heel ultrasound result, you need to have a follow-up DXA test, which will help in decisions about treatment.