Mum broke her hip at 71. I'm 52. Should I be asking for a bone scan now or waiting until they offer one?

Mum fell in the kitchen in June, nothing dramatic, and broke her hip. She's 71 and she is having a rough time of it, and the phrase the surgeon used, that the bone was "not what he'd hoped for", has been sitting in me ever since.

I'm 52. Everything I can find says bone density scanning is generally offered to women around 65, which is thirteen years away, and earlier if you have risk factors. A parent who fractured a hip is on every list of risk factors I've read. So on paper I think I have a case, but I don't want to walk in and be the woman who read some websites and is now demanding a scan, especially given my track record on this board with add-ons I didn't need.

Complicating things: the clinic that does my work screening has "bone density" on the add-on menu. When I rang to ask, it's not the big scan, it's an ultrasound thing on your heel. Cheap, immediate, no waiting list. Is that a reasonable first step or is it the health screening equivalent of a mall foot massager?

Heel ultrasound is not the same test and I'd be careful with it. Mine came back "low" at a pharmacy stand years ago and I spent a fortnight upset before a proper scan said I was fine. The units aren't even the same as the ones a specialist uses.

What it did do was get me in the door, so I can't say it was worthless. Just don't treat the number as an answer.

Ask for the proper thing. A DXA is not a big deal as procedures go, you lie on a table fully clothed for about ten minutes, radiation is tiny, and it gives you a T-score you can actually act on. Above minus one is normal, between minus one and minus two point five is the low bone mass band, minus two point five or below is osteoporosis. I know this because my sister came out at minus one point eight at 54 and has been on the "do something about it now" plan since.

Parental hip fracture is genuinely a recognised risk factor, you're not making that up off a website. There are also risk calculators the doctor can run in the room, which take family history, weight, previous fractures, steroids, smoking and drinking into account and spit out an estimate. Might be that the calculator gets you the scan rather than the request does.

gregor_runs said:

Might be that the calculator gets you the scan rather than the request does.

That's a much better way in than "please can I have a scan", thank you. Turning up with the family history and letting them do the sums makes me feel less like a hypochondriac with a browser.

Devil's advocate: what would you actually do differently if the scan came back mildly low? Because if the answer is weights, walking, vitamin D and sorting your diet out, you could do all of that on Monday without a scan and without a bill.

Not saying don't. Saying it's worth knowing which answers change your behaviour and which just formalise what you already know.

Annika, I want to defend you against your own opening paragraph. You're not "the woman who read some websites". You're someone with a first-degree relative who fractured a hip, which is one of the specific things clinicians ask about when deciding whether to bring bone density testing forward. Bringing that to an appointment is exactly how risk-based screening is supposed to work, and it is the opposite of the pattern you're worried about repeating. The neck ultrasound you regret was a test with no question attached to it. This one has a question attached: does my family history move my timeline?

dgb's challenge is a good one and I'd hold both things at once. The lifestyle side is worth starting regardless of any result, and a number can be what makes an abstract intention concrete. Speaking from my own experience with a blood pressure reading: I had known for years what I ought to be doing, and I did not do it until a number made it real. That is not a very rational fact about me, but it is a true one, and I suspect it's true of quite a few people reading.

On the heel device, I'd only add what our bone density screening guide sets out, which is that the central scan is the reference test and other devices are best thought of as a nudge toward it rather than a substitute for it. And the broader point that keeps coming up in this section is in how to build your own screening plan: the tests worth buying are the ones answering a question you can state out loud. You can state yours. Go and ask.

Small update, no ending yet. Saw the GP on Monday, took the family history rather than a request. She ran one of the calculators Gregor mentioned, and the outcome is that I'm borderline on it, which apparently means it's a judgement call rather than an automatic yes.

She's asked me to come back with a couple of things I didn't have to hand (how old Mum was at her earlier fracture, which I didn't know about until my sister mentioned it on the phone that evening, and whether there's anything similar on Dad's side). So the answer to my own question is currently "possibly, ask again in a fortnight with better family notes", which is not the tidy resolution I wanted but is more than I had.

Starting the weights either way. dgb's point stands.

The "I didn't know about the earlier fracture until my sister mentioned it" thing is so common it should be on the leaflet. Half of us are walking around with an incomplete version of our own family history and only find the missing bits by ringing a sibling.