As scientists learn more about COVID-19, it has become clear that the virus impacts people in different ways and that symptoms can range in severity.
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Leading-edge Osteoporosis Treatment
Part of the Massachusetts General Hospital Endocrine Unit, the Bone Density Center provides leading-edge bone density testing services to help your primary care physician or specialist develop a treatment program tailored to your needs.
Osteoporosis is the most common cause of low bone mineral density. Bone density testing is very effective in diagnosing this condition, determining your risk for fractures and monitoring your response to therapy.
Early diagnosis of osteoporosis enables your doctor to begin proactive treatment to reduce your risk for fractures. Even if osteoporosis is diagnosed at a more advanced stage, you can still realize substantial benefits from treatment.
What to Expect
Based on your doctor’s referral, the Bone Density Center performs one of several tests to determine the causes of your symptoms and provide your primary care physician or specialist with information to help develop a treatment plan.
The standard test for men, women and children measures bone density of the spine and hip. In certain cases, we may also run tests to identify any fractures in your spine or to measure the bone density of your forearm or whole body.
All of our tests use dual-energy X-ray absorptiometry (DXA), making for a pain-free process that uses very low doses of radiation and lasts only about 10 minutes.
Most medical insurance companies cover bone density testing for patients with certain medical conditions, though many insurers limit the frequency of these tests.
Bone density scans should not be performed for one week following any barium examination (such as barium swallow, GI series, barium enema, abdominal CT) or nuclear examination.
It is recommended that patients avoid taking calcium supplements, TUMS (antacids), or multivitamins for at least 24 hours prior to their scan.
On the day of the scan, patients are encouraged to wear loose, comfortable clothing, preferably without metal (e.g. zippers, buttons and underwire bras).
Understanding Your Results
Our standard reports include measurement of your bone density and how it has changed over time. Your results are compared with the normal range for:
- People who are the same age, gender and ethnicity as you (your Z-score)
- Healthy young adults who are the same gender and ethnicity as you (your T-score)
Your bone density reports are available to your doctor within 3 to 5 business days and include general recommendations for medical management.
If your bone density is normal, you may not need further testing for years. If your bone density is low or you have had a fracture, you may benefit from medical treatment and/or future monitoring with bone density tests.
Most forms of osteoporosis can be treated by your primary care physician. If you have a complex case, your doctor may refer you to Mass General Endocrine and Osteoporosis Associates for specialized care.
About This Program
Leaders in the Field
Founded in 1976, the Massachusetts General Hospital Bone Density Center was the first center of its kind in the eastern United States. The Bone Density Center played an important role in the development of dual-energy X-ray absorptiometry (DXA), the current standard for measuring bone mineral density. DXA allows physicians to diagnose osteoporosis and related bone diseases early, often before you suffer a fracture.
DXA is also an important tool for researching and developing new osteoporosis treatments. Using DXA, our physicians and researchers can determine the effectiveness of specific treatments in groups of patients and in individuals. This capability has accelerated the development and application of improved methods to treat osteoporosis.
Mass General was the first hospital to employ DXA in a clinical setting and in osteoporosis research. Robert Neer, MD, Bone Density Center founder, wrote the first paper describing the use of DXA in humans. He also coined the term "T-score" to describe the density of an adult's bones compared with that of the average young adult of the same gender and ethnicity. This score serves as a rough indicator of the need for osteoporosis treatment.
The Latest Diagnostic Technology
Our diagnostic technology includes:
- Spine bone mineral density (in both front-to-back and side views)
- Hip bone mineral density (in the femoral neck and total hip)
- Forearm bone mineral density
- Whole-body bone mineral density
Recently, we added a new technique called vertebral fracture analysis (VFA). This test of the lower and upper spine can detect the presence of a fracture. If you have a vertebral fracture you have much higher risk of having another fracture in the next three to five years.
In addition, we are one of the few programs in the United States using a dedicated, high-resolution CT scanner for research measurements of bone density and bone structure. This equipment produces images down to the microscopic level—and appears to provide even better diagnostic information than DXA technology. While the scanner is currently used for experimental purposes only, it may one day become the standard for bone density testing.
Balancing Clinical Care and Research
We often recruit for clinical trials that offer access to new and promising therapies.
Search for open clinical trials
The same endocrinologists who analyze and interpret our patients' bone density tests also conduct osteoporosis research and have successfully competed for external research-support funds.
Training the Next Generation
As part of an academic medical center, our physicians are committed to training the next generation of endocrinologists and osteoporosis experts. Through the Endocrinology Fellowship Program, we help to prepare physicians for careers in clinical and academic medicine.
The Massachusetts General Hospital Bone Density Center offers dual-energy absorptiometry tests (DXA) for research studies.
A scanning appointment is approximately 15 minutes and involves low radiation exposure (less than a routine chest x-ray). With applications for both cross-sectional and longitudinal research, investigators have employed our facilities and expertise to study a variety of bone-related diseases and body composition endpoints with participants ranging in age from children to older adults.
The research goal of the Bone Density Center is to provide research facilities and personnel on a per study basis, allowing investigators access to important information about bone density without requiring special expertise and equipment. We perform rigorous quality control measures to ensure high quality data and reproducibility. Our scans are performed by DXA technicians (certified by the International Society of Clinical Densitometry, ISCD) and are additionally independently reviewed by ISCD-certified physicians.
To begin a DXA study or to inquire further about research rates, please contact the Director, Dr. Elaine Yu.
Director: Elaine Yu, MD
Associate Director: Joy Tsai, M.D.
Managing Coordinator: Deborah Fitzgerald
Facilities and Equipment
Location: MGH Bone Density Center, 10 Emerson Place, Suite 1, Boston, MA 02114
Major Equipment: Hologic Discovery DXA system (Hologic, Waltham, MA)
Lumbar Spine (PA and lateral) and Proximal Femur (femoral neck and total hip) Density
The Bone Density Center can assess clinically relevant skeletal sites with high quality control.
Scanning of the 1/3 distal radius provides information about a skeletal site predominantly composed of cortical bone.
Whole Body Bone Density and Body Composition
Whole body bone density and body composition analysis provides information about bone mineral content, lean body mass, fat mass (percent fat), and visceral adipose tissue (VAT).
Vertebral Fracture Analysis
This test of the thoracic and lumbar spine can detect the presence of a fracture. Radiographically-identified vertebral fractures increase the risk of future fractures over the next three to five years.
Scan results including all measurements for a specific research protocol are provided on a monthly basis. Additional reports can be requested when needed to respond to deadlines for grant submissions or publications.
Each scan is initially analyzed by a senior technician and then reviewed by a physician member of the Bone Density Center. All technicians and physicians are certified by the International Society for Clinical Densitometry (ISCD).
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