From the Guidelines
For most adults, a DEXA scan is recommended every 2 years, but the frequency can vary based on individual risk factors, such as age, sex, and medical conditions. The American College of Radiology recommends that the frequency of DEXA scans be based on individual risk factors, with more frequent scans for those at high risk for accelerated bone loss 1. According to the most recent guidelines, patients with risk factors, such as chronic renal failure, rheumatoid arthritis, or those receiving glucocorticoid therapy, should have a DEXA scan every 1-2 years 1. In contrast, those with normal bone density and no risk factors may only need a DEXA scan every 5-10 years. It's also important to note that patients on osteoporosis treatment should have a DEXA scan every 1-2 years to monitor treatment effectiveness 1. Some studies suggest that younger adults with risk factors, such as low body weight or prior fractures, may need more frequent DEXA scans, every 2-3 years 1. However, the decision on the frequency of DEXA scans should be made on a case-by-case basis, taking into account the individual's specific risk factors and medical history. Regular DEXA scans can help diagnose osteoporosis and assess fracture risk, allowing for early detection of bone loss and timely intervention to prevent fractures and maintain bone health. Key factors to consider when determining the frequency of DEXA scans include:
- Age and sex
- Medical conditions, such as chronic renal failure or rheumatoid arthritis
- Risk factors, such as low body weight or prior fractures
- Osteoporosis treatment
- Changes in bone density or medical history. By considering these factors and following the most recent guidelines, healthcare providers can make informed decisions about the frequency of DEXA scans for their patients 1.
From the Research
Frequency of DEXA Scans
The frequency of Dual-Energy X-ray Absorptiometry (DEXA) scans is not strictly defined, but rather depends on various factors such as age, risk factors, and bone mineral density (BMD) results.
- Adults over the age of 65, post-menopausal women, and those with risk factors such as previous fractures are recommended to receive DEXA scans every one to two years 2.
- For younger individuals, DEXA scans are recommended only in the presence of clinical risk factors for low bone mass, such as low body weight, prior fracture, high-risk medication use, or a disease or condition associated with bone loss 3.
- The diagnosis of osteoporosis can be confirmed by DEXA, but this should only be performed in patients who have an increased risk of fracture on the basis of clinical risk factors 4.
Special Considerations
- Vertebral fractures are generally taken as diagnostic of osteoporosis, even if spine BMD values are not in the osteoporotic range 4.
- In patients with glucocorticoid-induced osteoporosis, therapy should be considered at higher levels of BMD than in postmenopausal osteoporosis, with a BMD T-score of <-1.5 4.
- The application of a screening strategy to identify women at 'high risk' of osteoporosis can help estimate the number of women requiring DEXA scans 5.
Clinical Practice Guidelines
- Clinical practice guidelines recommend the assessment of clinical risk factors for osteoporosis as the basis of osteoporosis diagnostics, which should be carried out quickly after a fracture 6.
- If risk factors are present in a postmenopausal woman or a man aged 50 or above, bone densitometry testing with DEXA is recommended 6.