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4499 Medical Drive #225, San Antonio, Texas 78229  210.616.0836 



DXA Bone Density Testing San Antonio


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Appointments available usually within 24-36hrs!!


We review the results with you immediately after the procedure. 

Takes 1 Hour for these 9 Scans, Analysis and Review.  Includes detailed report for you and your referring Doctor or Doctor of choice. Cost is $300 and we do not bill Insurance. 

This will be a unique educational experience. You will learn the status of your bone health, risk factors that have contributed to your bone density and the modifiable risk factors and behaviors you can change to maintain and improve your bone density. And, you can use Your For your DXA Bone Density Testing!

Dr. Christian has been doing DXA Bone Density Testing for over 23 years in San Antonio.  We evaluate your current bone health with our Hologic Discovery A Model DXA Bone Densitometer, which has the ability to do lateral L2-L4 scans and a Instant Vertebral Analysis.  This machine is similar to an x-ray but emits less radiation than flying on a coast-to-coast flight and much less than a standard chest x-ray.  It is the gold standard to determine bone density status, your risk for fractures and for following treatment programs.  In 2000, after obtaining a Hologic QDR 4500 Scanner, Dr. Christian received training in DXA Scanning and interpretation at the "Atlanta Osteoporosis Center" under the mentorship of Dr. Gratton Woodson Jr. and his son, the authors of "Zephyr, The OsteoReport", software designed to create a detailed bone density report with data from the QDR4500.  After upgrading to the Discovery A, Dr. Christian and staff were certified in DXA Scanning by Hologic Trainers and he serves as the Radiation Safety Officer.

There are other screening machines which look at the heel or forearm but unless you have had a scan which looks at the L1-L4 Lumbar Spine, Bilateral Hips, Bilateral Forearms and an Instant Vertebral Fracture Analysis (IVA) you really don't know the status of your bone health!! 

Your results are compared to a young person (approximately age 30) with maximum bone density (T-Score) and with someone your age (Z-Score).  These scores indicate if you have decreased bone density and will help predict your risk of future fractures. Treatment decisions, in general are based on the T-Scores, and in some cases the FRAX Score (see below). The World Health Organization has defined "low bone density" (often referred to as Osteopenia) as T-Scores of -1.0 to -2.5 and "Osteoporosis" as T-Scores less than -2.5.   Z-Scores are used for men less than age 50 and pre-menopausal females.   Z-Scores less than -2.0 are considered "below the expected range for age" and Z-Scores above -2.0 are considered "within the expected range for age".

Our Routine Protocol for Clients Requesting DXA Bone Density Testing

Includes the Following Testing

Lumbar AP (Anterior Posterior) & Supine Lateral Bone Density

Bilateral Hips (Both Hips are Scanned and Analyzed)

FRAX Fracture Risk Analysis (Primarily useful for post menopausal females)

Bilateral Forearms (Both Forearms are Scanned and Analyzed)

High Definition AP & Lateral Instant Vertebral Analysis (IVA) to look for vertebral fractures

and Abdominal Aortic Calcifications

DXA Whole Body Composition with Visceral Fat Analysis

Lumbar AP (Anterior Posterior) & Supine Lateral Bone Density

This is an AP DXA Scan of the L1-L4 Vertebra in a 58 year old post menopausal female. The Total T-score of -0.7 indicates normal bone density but there is evidence of probable artifact elevation of the measurements due to the sclerosis and calcifications seen in the posterior elements (Spinous Processes and Facet Joints), so her true Bone Mineral Density is probably lower. Lateral Views of the spine might give a better measurement. Her Supine Lateral view of the spine is below.


This is the Lateral DXA Scan of the L2-L4 Vertebra only available on a few DXA Scanners such as our Discovery A. These Lateral views eliminate any artifact elevation of bone density due to calcifications in the posterior elements and give us a bone density measurement of these vertebra without any artifact.  This study does indeed show that this lady has lower bone density measurements in the L2-L4 vertebra which was not apparent in the AP Exam. This information might influence the treatment program for this patient. The scanner also allows for creation of detailed sampling areas in the middle of these vertebral bodies to get a more precise measurement of the bone density in the interior of the vertebra for following response to treatment. 

Bilateral Hips (Both Hips are Scanned and Analyzed)

This is a DXA Scan of the Left Hip in a 67 year old male which shows a T-Score of -1.2 for the Total Hip and a T-Score of -2.0 in the neck. This is a definite diagnosis of low bone density of the Hip.  The Right Hip results are shown next.

The Right Hip Scan shows a T-Score of -1.1 for the Total Hip and a T-Score of -2.2 in the Neck of the Right Hip. The FRAX score discussed next uses the lowest Neck Measurement to determine the 10 Year risk of a Hip or other Major Osteoporotic Fracture. 

The Discovery A also automatically calculates your FRAX Score, a tool developed by the University of Sheffield in 2008

to estimate your 10 year risk of either a Hip or other Major Osteoporotic Fracture (vertebral, shoulder, forearm)

The risk is based on the lowest T-Score of the Neck of the Hip, where most fractures occur, your age, race, country

 and 7 questions about your medical history.  

The FRAX results shown are in the 67 year old male above and show the influence of drinking

more than 3 units of alcohol a day on the risk of a hip or other major fracture.

These FRAX Scores show the 10 Year risk of a Hip Fracture or other Major Osteoporotic Fracture based on the factors discussed above.  It is apparent that alcohol intake greater than 3 units per day markedly increases the 10 year risk of a Hip Fracture from 2.3% to 3.4% and the risk of a Major Osteoporotic Fracture from 8.5% to 11%. This information might be helpful in counseling a patient about this particular risk factor.

Bilateral Forearms (Both Forearms are Scanned and Analyzed)

These are the forearms scans of a 24 year old Hispanic female with a history of a eating disorder. The negative T-scores show evidence that this young lady has slightly lower bone density than females age 30 (T-Score) or females her age (Z-Score). Women continue to develop their bone density up until about age 30 so there still is time to improve these measurements.  Her T-Scores  and Z-Scores of the Femoral Necks and L1-L4 spine also showed that she was lagging behind women age 30 and those her age. Possibly, the failure to achieve bone density equal to her peers was due to her dietary habits. This is a bothersome trend that we are seeing more and more as young women have increasingly bad eating habits and eating disorders such as anorexia and bulimia.  These scores can improve with attention to nutrition and exercise, but if not addressed, this young lady may enter menopause without ever achieving her maximum bone density as a young adult. 

High Definition AP & Lateral Instant Vertebral Analysis (IVA) to look for vertebral fractures


The Discovery A Model allows for both High Definition AP and Supine Lateral Instant Vertebral Analysis of the Spine to look for evidence of Vertebral compression fractures which are sometime silent but when present indicate a significant level of loss of bone density.  Patients with these fractures are considered to have a diagnosis of Osteoporosis and should be treated to avoid future fractures. The Hologic Software analyzes each vertebra separately and can detect compression changes.


The Lateral Scan can also be used to detect Abdominal Aortic Calcification which is an indication of significant atherosclerosis and predictive of future heart attacks and stroke.



















See Detection of Abdominal Aoritic Calcification with IVA


 DXA Whole Body Composition Testing

58 year old female, 36.9% Body Fat.Table shows 5 major regions and body fat % in each. We can even define subregions such as chest/back and legs separately.


















DXA Body Composition is a research level tool and can be used to help set goals for weight loss and gaining of muscle. You can watch the yellow disappear and the red increase.   This lady has a body fat % of 36.9%, too high for her age.


See our Modified Zone/Paleo Nutrition Prescription and  how we would combine it with Hi-Lo Strength Training to get the body fat % to 25%, much more reasonable for a 58 Year Old female!!


This is our Fillable Intake .pdf Form for DXA Bone Density Testing. It includes a Questionnaire to determine your Risk Factors and must be completed prior to your procedure.  

National Institutes of Health Web Site Bone Health and Osteoporosis
A Report of the Surgeon General


In 2004 the Surgeon General of the United States, Richard Carmona,  issued the first US Public Health Service report concerning Bone Health and Osteoporosis.  It was/is a sobering document which indicates that loss of bone density is a much more serious problem that we have previously thought and unless we change our eating and exercise habits the problem will progress very rapidly.

Already, 10 million Americans over the age of 50 have developed severe bone thinning or osteoporosis; an additional 34 million have started down that road and have an increased risk of fractures. To avoid bone loss, Carmona’s report recommends getting the recommended daily amounts of calcium from leafy green vegetables, milk and cheese, and of Vitamin D; maintaining a healthy weight and being physically active; and trying to reduce the risk of falls. Ignoring the problem is expensive. Americans spent as much as $18 billion on hospital, physician and nursing home care to treat the 1.5 million fractures attributed to osteoporosis in 2002. The cost could double or triple in coming decades.

Update Medicare White Sheet 2017 "Medicare Cost of Osteoporotic Fractures)

 Many people think of osteoporosis as a disease of elderly women that causes them to appear stooped over.  These vertebral fractures that cause the hunching over (called "dowager's hump"), result in pain, loss of height, reduced lung capacity and decreased exercise tolerance.  But this is only seen when the loss of bone density is at its late stages. 

We develop our bone density between about age 13 and 30.  After age 30, we all may lose our bone density at a slow rate.  Some people, especially young women and some men during adolescence and young adulthood never develop their maximum bone density.  This can be due to eating disorders such as anorexia, low calcium intake, too many sodas/alcohol/smoking/vaping/drug use and sometimes due to too much exercise which results in amenorrhea. Estrogen balance is disrupted when amenorrhea occurs and bone formation is impaired. This is called The Female Athlete Triad, eating disorders, menstrual disturbances and low bone mass.

 In women, after menopause, the rate of bone loss may increase. While most fractures due to osteoporosis usually do not develop until around age 65, osteoporosis has a long, quiet development period when there are no symptoms at all.  It is important for young and middle aged adults to become aware of osteoporosis while there is still time to prevent it.  Osteoporosis is not just a disease of women.  Men account for 20% of those with osteoporosis.  Most people do not know they have osteoporosis because there may be no symptoms until they break a bone.  By that time, the disease is far advanced.  Women with histories of dieting or eating disorders early in life may never achieve maximum bone density and unwittingly set themselves up for problems possibly in their 50's or early 60's.  

After the scan we will spend about 30 minutes going over the scan and your risk factors found on our comprehensive "Risk Factor Questionnaire" We have found several young ladies in their 30's with early signs of that their bone density is lower than others their age.   In addition, men are not immune to loss of bone density and many feel that this is a problem that is under diagnosed in men.  In our experience it is rare to find normal bone density in a man who has a  very stressful lifestyle such as a professional or a entrepreneur. These men with lots of stress in their lives have many factors which impair bone health.  Stress lowers Testosterone and Growth Hormone levels which are good for bones and raises cortisol levels which is bad for bone health.  In addition, these men often do not get enough good restorative sleep when repair and growth occur. And to make things worse, they don't exercise, eat poorly and may smoke or drink too much alcohol. And we have yet to see a man who takes a Calcium or Vitamin D Supplement regularly!!

We submit a detailed report for the referring M.D. and the patient gets a copy of the report for their personal records. We make recommendations for nutrition and exercise strategies.  We leave medical treatment decisions for FDA approved drugs up to the referring doctor the patients doctor of choice. 

Our recommendations always include Hi Lo Strength Training which was developed in part in the early 1980's by Ken Hutchins, the founder of SuperSlow Strength Training.  He was working with Nautilus at the time and Nautilus was given the "Nautilus Osteoporosis Project" and asked to design a strength training program for frail seniors with osteoporosis.  The Original Nautilus Protocol was a 2 second Positive, 4 second Negative repetition.  The seniors were hurting themselves moving the weights this fast, so Ken slowed it down to 10 seconds up and 10 seconds down.  The seniors could do this, coaching was easier, they got a lot stronger and bone density improved, however little data was forthcoming due the the crude measurements of bone density at that time.  To quote Ken Hutchins "And if we can assume the body to be logical then bone strengthening should result from muscular strengthening"  It would make no evolutionary sense to allow the muscle to get stronger and not allow the tendon and bone attached to the tendon to get stronger at the same time.  Since aerobics does not reliably build strength or muscle mass, it may not the best choice to improve or maintain bone density.


Some common osteoporosis risk factors include:

  • Estrogen deficient postmenopausal women
  • Caucasian or Asian Race
  • History of Fracture as an Adult
  • Maternal history of osteoporosis or other 1st degree relative
  • High caffeine intake
  • Smoking/Vaping, drug use and/or high alcohol consumption
  • History of eating disorder (Often seen in young women) or malabsorption syndromes
  • Low calcium intake
  • Weight less than 127lbs most of life
  • Athletic Amenorrhea "Female Athlete Triad"
  • Inadequate physical activity
  • Chronic corticosteroid use, even inhalers with steroids.
  • High levels of Stress
  • Any organ transplant or autoimmune disease.


When Should I be Scanned?  My Opinion...FWIW

1.  Age 25-30 to identify women & men who may not have achieved full bone mass density early in life if risk factors are present.

2.  Age 40-45 to identify Bone Mass Status prior to Menopause.  Men should get a baseline scan at this time.

3.  Age 50-55 to identify Bone Mass Status in the early post menopausal years and to determine if there is increased fracture risk.


DXA Bone Density Testing

 DEXA Bone Density Testing



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