From the Guidelines
DEXA scans are recommended every 1-2 years for individuals at risk for osteoporosis, with the frequency varying based on individual risk factors, as stated in the most recent and highest quality study 1. The recommended frequency of DEXA scans depends on various factors, including the patient's age, sex, and presence of risk factors for osteoporosis.
- For postmenopausal women and men over 50 with risk factors, initial screening is recommended, with follow-up scans every 1-2 years if bone loss is detected 1.
- Those taking osteoporosis medications usually need scans every 1-2 years to monitor treatment effectiveness 1.
- Younger individuals without risk factors generally don't need regular scans, but may require monitoring if they have specific diseases or medical conditions that affect bone density 1.
- People with normal initial results and no risk factors may wait 5-10 years before another scan, but this interval may be shorter for those with certain medical conditions or risk factors 1. The frequency of DEXA scans may also be influenced by the patient's clinical state, national clinical guidelines, cost, and reimbursement, with suggested intervals between BMD testing typically ranging from 1-5 years after starting or changing therapy 1.
- It is essential to note that DEXA scans should be performed on the same machine, and the measurement of hip BMD is the most reliable way of evaluating hip fracture risk, whereas imaging of the spine is optimal for monitoring treatment response 1.
- The use of minimal radiation and the provision of valuable information about bone mineral density make DEXA scans a crucial tool in assessing fracture risk and guiding treatment decisions 1.
From the Research
DEXA Scan Recommendations
- DEXA scans are recommended for patients with an increased risk of fracture, with a 10-year risk of major osteoporotic fracture of > 10% 2
- The scan should be considered for women 65 years and older or postmenopausal women with clinical risk factors, and for men 70 years and older or those with clinical risk factors 3
- Adults over 65, post-menopausal women, and those with risk factors such as previous fractures are recommended to receive DEXA scans every one to two years 4
- Patients at high risk of osteoporosis, such as those undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), should be screened for osteoporosis via DEXA scan within 3 years 5
Screening Guidelines
- The Bone Health and Osteoporosis Foundation recommends screening men 70 years and older and men with clinical risk factors 3
- The U.S. Preventive Services Task Force did not find sufficient evidence to support routine screening in men 3
- Patients taking glucocorticoids should be referred for bone density assessment if they are at relatively low risk of osteoporosis (<65 years, no previous fragility fracture) 6
Treatment and Prevention
- Osteoporosis can be diagnosed by a T-score of -2.5 or less or the presence of a fragility fracture 3
- Treatment of osteoporosis is influenced by the patient's fracture risk, the effectiveness of fracture risk reduction, and medication safety 3
- Bisphosphonates, denosumab, and hormonal therapies are among the most common pharmacologic treatments for osteoporosis 4