What are the treatments for osteoporosis diagnosed by DEXA (Dual-Energy X-ray Absorptiometry) scan?

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Last updated: February 8, 2025View editorial policy

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From the Guidelines

Treatments for osteoporosis diagnosed by DEXA scan include pharmacologic therapies such as bisphosphonates, peptide hormones, and selective estrogen receptor modulators, as well as non-pharmacologic interventions like dietary and supplemental calcium and vitamin D.

Treatment Options

  • Bisphosphonates: alendronate, risedronate, ibandronate, and zoledronic acid are commonly used to prevent bone resorption 1.
  • Peptide hormones: teriparatide and calcitonin are used to treat osteoporosis, with teriparatide being a 1,3,4 amino acid fragment of parathyroid hormone 1.
  • Selective estrogen receptor modulators (SERMs): raloxifene and bazedoxifene are used for the prevention and treatment of osteoporosis in postmenopausal women 1.
  • Denosumab: a biologic agent that is used to treat osteoporosis, particularly in patients with a high risk of fracture 1.
  • Dietary and supplemental calcium and vitamin D: essential for maintaining bone health and preventing osteoporosis, with recommended daily intake of 1200 mg of calcium and 800-1000 IU of vitamin D3 1.

Monitoring and Assessment

  • DXA scans: used to diagnose and monitor osteoporosis, with T-scores and Z-scores used to assess bone mineral density 1.
  • FRAX tool: used to assess fracture risk, taking into account clinical risk factors and bone mineral density 1.
  • Biochemical markers of bone turnover: not recommended for monitoring response to therapy, but serum vitamin D levels can be checked to guide supplementation 1.

From the Research

Treatment Options for Osteoporosis Diagnosed by DEXA Scan

The following treatment options are available for osteoporosis diagnosed by DEXA scan:

  • Fall prevention
  • Adequate intake of calcium (at least 1,200 mg per day) and vitamin D (at least 700 to 800 IU per day) 2
  • Treatment with a bisphosphonate as a first-line treatment 2
  • Raloxifene, calcitonin, teriparatide, or hormone therapy may be considered for certain subsets of patients 2

Importance of DEXA Scan in Osteoporosis Diagnosis and Treatment

DEXA scan is an important tool in the diagnosis and treatment of osteoporosis, as it:

  • Measures bone mineral density (BMD) at the spine and hip 3, 4, 5
  • Helps clinicians advise patients about the appropriate use of antifracture treatment 3, 5
  • Has a proven ability to predict fracture risk and target antifracture therapies 3, 5
  • Is used to monitor response to treatment 3

Recommendations for DEXA Scan Screening

The following groups are recommended to undergo DEXA scan screening:

  • All women 65 years and older 6, 2
  • Women 60 to 64 years of age with increased fracture risk 2
  • Women 50 to 64 years with certain risk factors 6
  • Men 70 years and older, as recommended by some organizations 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and treatment of osteoporosis.

American family physician, 2009

Research

Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA).

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2004

Research

Role of dual-energy X-ray absorptiometry in the diagnosis and treatment of osteoporosis.

Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry, 2007

Research

Evaluation and Treatment of Osteoporosis.

The Medical clinics of North America, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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