One alternative is to scan another area of your body, such as the bones in your wrist. You can sit next to the scanning table and place your hand on it while the machine scans. Another option is peripheral DXA scans. This is a smaller machine that scans the bones in your wrist, fingers, leg or heel. Peripheral DXA machines are usually found in doctor's offices, pharmacies and health fairs. They do not yet have a uniform reference standard and the results may therefore be less reliable. As well, they're not ideal sites to monitor the effectiveness of treatment, but if it's the only option you have, work with what you've got.
The Quantitative Ultra-sound (QUS) is a new test using a much smaller machine and can be done in doctor's offices. The ultrasound wand is applied to your heel and the test is completely noninvasive and radiation-free. It is also quite reasonable in cost and can be a good alternative to establish a baseline or indicate whether further testing is necessary. The QUS received FDA approval last year and availability may therefore be limited.
Another option is a Quantitative Computed Tomography test (QCT). This can also be used if you have titanium in the area is scanned by the DXA, such as hip replacements or hardware along your spine from back surgery. A regular CT scanner with bone density software is used in this test. It has the benefit of being able to read around the titanium, although it may overestimate your score. However, CT scans expose you to a very high level of radiation and are more expensive than the DXA scans.
Talk to your doctor about the different options available to you and what would give you the best result giving your individual needs and limitations.
Prevention is Key
With so many potential risk factors there can be with RA, you might feel a bit daunted by what it will take to prevent or manage osteoporosis. However, there are a number of things you can do. A diet rich in calcium and vitamin D is an essential part of making sure your bones are as healthy as possible. Weight-bearing exercise is also crucial in building strong bones and this can be a challenge when you have RA. You don't have to do a high-impact exercise for it to have an effect. Lower impact types of exercise such as walking, tai chi and walking in shallow water can also be effective in building your bone. The key is to do what you can. Talk to your doctor about the best exercise for you, or ask for a referral to a physical therapist who can help you design an exercise program that protect your joints.
Lene is the author of the award-winning blog The Seated View