From the Guidelines
For individuals with osteopenia, DEXA scans are typically recommended every 2 years, depending on individual risk factors, as stated in the most recent and highest quality study 1.
Key Considerations
- The frequency of DEXA scans may vary based on the presence of risk factors, such as medical conditions that could alter bone mineral density (BMD), chronic renal failure, rheumatoid arthritis, eating disorders, organ transplantation, prolonged immobilization, and conditions associated with secondary osteoporosis.
- Individuals receiving glucocorticoid therapy for more than 3 months, hypogonadal men, and those beginning or receiving long-term therapy with medications known to adversely affect BMD may require more frequent monitoring.
- The American College of Radiology recommends follow-up for premenopausal women and men 20 to <50 years of age based on underlying clinical conditions, with a monitoring time interval of 1 to 2 years if there is a high risk for accelerated bone loss, but otherwise every 2 years if there are risk factors 1.
Additional Recommendations
- Other studies, such as 1 and 1, also support the recommendation of repeating DEXA scans every 2 years in patients with osteopenia, with some suggesting more frequent monitoring in certain situations, such as rapid bone loss or significant risk factors.
- However, the most recent and highest quality study 1 takes precedence in guiding clinical practice.
- It is essential to consult with a healthcare provider to determine the most appropriate testing schedule for individual patients, taking into account their specific risk factors and medical conditions.
From the Research
Frequency of DEXA Scans for Osteopenia
- The frequency of DEXA scans for individuals with osteopenia is not explicitly stated in the provided studies 2, 3, 4, 5.
- However, it is mentioned that osteopenia is defined by bone densitometry as a T score -1 to -2.5, and correction of calcium and vitamin D deficiency and regular physical activity can improve bone density in the hip and spine 4.
- The treatment of osteopenia is generally focused on correcting underlying causes, such as calcium and vitamin D deficiency, and promoting lifestyle changes, rather than frequent DEXA scans 4, 5.
- It is noted that widespread use of anti-osteoporotic medication in individuals with osteopenia is not advisable based on T-score alone, and treatment is typically considered for those with low energy fractures or high risk of future fracture 5.
- Vertebral fractures can be assessed using lateral x-rays from DXA machines, but the frequency of these scans is not specified 5.