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A dual-energy X-ray absorptiometry test (DEXA) scan is an imaging test used to determine bone density; specifically, it measures the calcium and mineral composition of bones. DEXA scans are usually performed to diagnose osteoporosis and bone loss that occurs with aging.

Bones lose density as we age, becoming more brittle and breakable. Osteoporosis is the medical term for this process. Many people do not realize that they are managing osteoporosis until they are injured; usually, a broken bone caused by a fall. Osteoporosis is a common condition among aging individuals but is especially prevalent among post-menopausal women.

DEXA scans obviously will not prevent injury, but they can help detect osteoporosis early on. This can help individuals managing low-density bone mass prevent injury. DEXA scans are recommended for:

• Individuals with a family history of osteoporosis
• Women over the age of 65
• Individuals who have a recent history of fractured bones
• Individuals who have experienced a loss of height (losing 1.5 inches in height is often a sign of compression in the spine caused by osteoporosis)
• Post-menopausal women who are over 5’7” or under 125 pounds
• Individuals who have a history of conditions that lead to bone loss (such as rheumatoid arthritis, kidney disease, or liver disease)
• Individuals who use steroidal medication that may cause bone loss (such as prednisone)
• Individuals who manage chronic diseases such as type 1 diabetes, liver disease, kidney disease, or thyroid conditions (like hyperthyroidism)
• Individuals who smoke cigarettes

DEXA scans are non-invasive X-ray tests that are used to determine bone density. This helps doctors detect bone loss and diagnose osteoporosis.

A bone scan requires an injection of lightly radioactive tracers that are sensitive to a certain type of camera. These tracers help produce images of bones. A bone scan is used to help doctors diagnose bone cancers and cancers that have spread (metastasized) from their original location to bones in the body. This primarily occurs in individuals who are managing prostate or breast cancer.

Unlike other forms of diagnostic imaging, little to no preparation is required for a DEXA scan. You do not need to fast or avoid taking medication before the test; however, if you take calcium supplements, you may need to stop taking these 24 hours before your scan.

Wear loose-fitting, comfortable clothes. Avoid garments with metallic buttons, zippers, or buttons. You will be asked to remove any jewelry prior to your scan, so it is generally recommended that you leave earrings, rings, necklaces, and any other piercings you have at home. Eyeglasses and dentures may also need to be removed. Depending on the clinic, and the part of your body being scanned, you may be asked to change into a medical gown during the test.

You will be asked to lie down on a specialized table. A mechanical arm will pass over your body. This device emits dual X-ray beams to produce images of your tissues and bones. The imaging recorded by the device is then sent to a monitor to be viewed by the technologist.

A DEXA scan most commonly examines the bones in the lower spine (lumbar vertebrae), the forearms, or the hip. The technologist may adjust your positioning with foam blocks to improve the accuracy of the picture.

The scan may take anywhere from 10-30 minutes. Afterward, you will be asked to change back into your street clothes. In most cases, you will be cleared to leave the clinic after you finish changing. No sedation is used for a DEXA scan, so you will be able to perform everyday activities once your appointment is over.

After you leave, a radiologist will review the images produced by the DEXA machine to determine bone density. They will then provide a report of the results to your primary care provider, who will discuss the findings with you. This may take 1-3 business days, depending on the clinic and when you received your scan. Depending on the results, you may be asked to come in for follow-up testing.

DEXA scan results consist of two different scores: your T-score and your Z score. The T-score compares your bone density with the bone density of a healthy young adult. Deviations from this number determine whether or not you have osteoporosis. A T-score is reported as:

• -1 and above is a healthy bone density
• -1 to -2.5 is considered osteopenia (low bone density, and a risk factor for osteoporosis)
• -2.5 and below is bone density low enough to be considered osteoporosis

Your Z-score measures your bone density against other individuals in your age group who are the same size and gender as you are. If this Z-score is abnormally high or low, it may indicate a medical condition that requires further testing.