From the Guidelines
DEXA scans are most commonly covered for diagnosing osteoporosis and assessing fracture risk in specific patient populations, including postmenopausal women over 65, men over 70, and individuals with risk factors for osteoporosis, as recommended by the American College of Radiology Appropriateness Criteria 1. The primary use of DEXA scans is to measure bone mineral density, particularly at the hip and spine, which are common fracture sites. Some of the key patient populations that are typically covered for DEXA scans include:
- Postmenopausal women over 65
- Men over 70
- Younger postmenopausal women with risk factors for osteoporosis
- Adults with fragility fractures
- Individuals taking medications associated with bone loss, such as long-term corticosteroids, aromatase inhibitors, or androgen deprivation therapy
- Patients with conditions known to cause secondary osteoporosis, such as rheumatoid arthritis, chronic kidney disease, hyperparathyroidism, or malabsorption disorders According to the most recent guidelines, DEXA scans are considered the gold standard for bone density measurement because they use low-dose X-rays to precisely measure bone mineral density 1. Early detection through DEXA scanning allows for timely intervention with appropriate medications and lifestyle modifications to prevent fractures, which can significantly impact quality of life and mortality, especially in older adults. The American College of Radiology Appropriateness Criteria recommend that DEXA scans be used to screen for osteoporosis in women over 65 and men over 70, as well as in patients with additional risk factors for fracture 1. In addition to diagnosing osteoporosis, DEXA scans can also be used to monitor response to osteoporosis treatment, typically at 1-2 year intervals. Overall, DEXA scans play a critical role in the diagnosis and management of osteoporosis, and are an essential tool for preventing fractures and improving quality of life in patients with osteoporosis.
From the Research
Common Diagnoses for DEXA Scans
- Osteoporosis: a common condition characterized by low bone mineral density (BMD) and an increased risk of fragility fractures, which can be confirmed by DEXA scan 2
- Paget's disease of bone: a focal disorder of bone remodelling that progresses slowly and leads to changes in the shape and size of affected bones, although DEXA scan is not the primary diagnostic tool for this condition 3, 4, 5
Diagnostic Criteria for Osteoporosis
- DEXA scan is used to confirm the diagnosis of osteoporosis by measuring BMD T-score values at the lumbar spine, femoral neck, or total hip 2, 6
- A BMD T-score of -2.5 or below is considered diagnostic of osteoporosis 2
- Vertebral fractures are also considered diagnostic of osteoporosis, even if spine BMD values are not in the osteoporotic range 2