Osteoporose: Kosten, Ablauf, Ergebnis: 3 Fragen zur Knochendichtemessung

3 Fragen zur Knochendichtemessung: Kosten, Ablauf, Ergebnis

Osteoporose, a condition characterized by weakened bones, often leads to bone fractures. When a patient visits a general practitioner or internist, a bone density test is usually recommended. This examination is performed in orthopedic and radiological clinics. Three questions, three answers:

1. How does a device determine the stability of one's bones? The standard method is the DXA procedure. It involves lying down on a table with a device passing over, similar to what orthopedist Dr. Uwe Maus describes. "The device is the X-ray arm. Simply put, it emits two weak X-rays. One goes into a region where soft tissues are, the other towards bone," explains Dr. Maus, head of Osteology at the German Society for Orthopaedics and Trauma Surgery (DGOU).

Ideally, this measurement is done at three points: the hips and lower back. "These measurement sites are the most informative when it comes to osteoporosis," Maus notes. The device then calculates how much the X-rays are absorbed by the bones. A computer derives the bone density from this value.

2. How should the results be interpreted? A score between 0 and -1 indicates healthy bone density. Anything lower suggests decreased density. A value lower than -2.5 is indicative of osteoporosis. However, the bone density test is not 100% accurate, as explained by orthopedist Dr. Jürgen Ropers of the Schön Klinik Neustadt. "There's a possibility that during the measurement, we might randomly hit a dense part of a bone, such as when there's arthritis present."

Although the bone density test is a crucial part of osteoporosis diagnosis, it's not the only factor. A doctor's consultation about pre-existing conditions, medications, and lifestyle habits, along with a blood test, are also essential.

3. Who covers the costs of the test? If there's no specific suspicion of osteoporosis, patients must pay for the test themselves, costing between 30 and 70 euros. If a bone fracture has already occurred, a bone density test is considered a covered service. This also applies if the doctor or internist intends to treat bone loss with medication based on specific findings.

For instance, the Consumer Center cites prolonged high-dose cortisone treatment as an example. If osteoporosis has already been diagnosed, affected individuals are entitled to a bone density test every five years at no cost. However, consumer advocates observed in a 2024 market check in North Rhine-Westphalia that many insured individuals cannot take advantage of this coverage, as some doctor's offices offer the test only as an individual health service (IGeL).

The Consumer Center recommends contacting the practices beforehand to inquire if they have permission to perform and bill the measurement as a covered service.