From the Guidelines
Bone density (DEXA) scans should be repeated every 2 years for individuals being monitored for osteoporosis or osteopenia, or every 1 year if medically indicated, as recommended by the most recent guidelines. The frequency of DEXA scans depends on various factors, including the individual's bone density results, risk factors for osteoporosis, and medical history. According to the American Society of Clinical Oncology (ASCO) clinical practice guideline 1, if the bone density result does not demonstrate osteoporosis or significant osteopenia with additional risk factors, and the FRAX calculation does not exceed a 10-year risk of hip fracture at 3% or greater, or 10-year risk of non-hip fracture at 20%, then repeat DEXA in 2 years or in 1 year if medically indicated.
Some key factors to consider when determining the frequency of DEXA scans include:
- Medical conditions that could alter bone mineral density (BMD), such as chronic renal failure, rheumatoid arthritis, and eating disorders 1
- Use of medications known to adversely affect BMD, such as glucocorticoids, anticonvulsant drugs, and androgen deprivation therapy 1
- Presence of risk factors for osteoporosis, such as previous fractures, family history of osteoporosis, and low body mass index 1
- Age and gender, as bone density changes slowly over time and may vary between individuals 1
The American College of Radiology (ACR) also recommends follow-up DEXA scans every 1-2 years for individuals with high-risk conditions, such as those with medical conditions that could alter BMD or those receiving long-term therapy with medications known to adversely affect BMD 1. However, for those with normal bone density and no risk factors, testing every 5-10 years may be sufficient. Ultimately, the healthcare provider should determine the specific testing schedule based on the individual's unique circumstances and medical history.
From the Research
Frequency of DEXA Scans
- The frequency of DEXA scans is not explicitly stated in the provided studies, but it can be inferred that the scans should be repeated at intervals to monitor bone density and structure over time 2.
- The study on DEXA and imaging in osteoporosis suggests that monitoring bone density and structure over time can help identify the effectiveness of therapy or the need for course corrections 2.
- However, there is no specific guideline on how often to repeat DEXA scans, and the decision may depend on individual patient factors and treatment plans.
Factors Influencing DEXA Scan Frequency
- The study on prolonged bisphosphonate release after treatment in women with osteoporosis found that alendronate was detected in patients up to 19 months after treatment cessation, suggesting that DEXA scans may need to be repeated at intervals to monitor bone density and structure during and after treatment 3.
- The study on the use of bisphosphonates in the treatment of osteoporosis notes that the optimal duration of treatment has not been clearly established, and long-term data are needed to determine the effects of treatment on bone mineral density and fracture risk 4.
- The study on alendronate and risedronate for the treatment of postmenopausal osteoporosis suggests that clinicians should review all available data and consider individual patient factors when making treatment decisions, which may include the frequency of DEXA scans 5.
Imaging Modalities for Osteoporosis
- The study on DEXA and imaging in osteoporosis highlights the importance of complementary imaging modalities, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), quantitative ultrasonography (QUS), and magnetic resonance imaging (MRI), in providing additional information on bone health and fracture risk 2.
- These imaging modalities can help overcome the limitations of DEXA and provide a more comprehensive understanding of bone health, which can inform treatment decisions and monitoring strategies.