November 14, 2018
Heel spur therapy by shock wave
Ask the Experts

Heel Scans for Bone Mineral Density

by Berkeley Wellness  

Q: How good are heel scans for measuring bone density?

A: Such ultrasound scans of the heel can be a quick and easy screening tool, often used at community-based screening programs because of the portability of the equipment. But 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. Starting at age 65, women should skip heel scans and go right to DXA testing, as should men over 70 and younger people at high risk for osteoporosis.

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

Besides using smaller, portable, and cheaper equipment, ultrasound testing has other advantages over DXA. It not only assesses bone density, but may also provide some information about the quality of the bone. And though DXA uses minimal radiation, ultrasound is radiation-free.

If you have an abnormal ultrasound result, you need to have a follow-up DXA test, which will help in decisions about treatment.

Also see Calcium in the Spotlight.