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What is a Bone Density Scan (DEXA)

Bone densitometry, also known as dual-energy x-ray absorptiometry (DEXA or DXA), utilizes a minimal dose of ionizing radiation to generate images of the body's interior, primarily focusing on the lower spine and hips, to assess bone loss. This technique is commonly employed to diagnose osteoporosis and evaluate an individual’s risk of developing osteoporotic fractures. DEXA is a simple, rapid, and noninvasive procedure and is the standard method for diagnosing osteoporosis.

When It Is Used

DEXA scans are primarily used to diagnose osteoporosis, which often affects women post-menopause but can also occur in men and, occasionally, children. The condition is characterized by a gradual loss of bone density, leading to fragile bones that are more susceptible to fractures. DEXA scans are effective in monitoring treatment effects for osteoporosis and assessing an individual's fracture risk, which can be influenced by various factors such as age, body weight, and a history of fractures.

Bone density testing is recommended for individuals who:

• Are post-menopausal women not on estrogen.
• Have personal or maternal histories of hip fractures or smoking.
• Are tall (over 5 feet 7 inches) or thin (less than 125 pounds) post-menopausal women.
• Are men with medical conditions linked to bone loss, like rheumatoid arthritis or chronic kidney/liver disease.
• Use medications known to cause bone loss, such as corticosteroids or high-dose thyroid medications.
• Have conditions like type 1 diabetes, hyperthyroidism, or hyperparathyroidism.
• Have experienced fractures from mild trauma.

The Vertebral Fracture Assessment (VFA), a low-dose x-ray examination of the spine, may be recommended for older patients under specific conditions.

How to Prepare

On the day of the exam, you may eat normally but should avoid taking calcium supplements for at least 24 hours beforehand. Wear loose, comfortable clothing that doesn’t have metal fasteners, and remove any jewelry and metal objects that might interfere with the x-ray images. If necessary, you may be asked to change into a gown. Inform your physician if you’ve had a barium exam or a contrast injection recently, as you may need to wait 10 to 14 days before the DXA scan. Pregnant women should notify their doctor and technologist before the procedure.

How the Procedure Works

During a DEXA scan, you will lie on a padded table while an x-ray generator is positioned below you, and a detector is above you. The examination usually involves scanning your hip and spine. To properly assess the areas, your legs may be supported on a padded box. The detector moves slowly over the area, generating images.

Peripheral DEXA tests are simpler and involve placing the forearm, hand, or foot in a small device for a quick reading. The VFA, performed on the DXA machine, adds only a few minutes to the overall procedure time.

The DEXA test typically takes about 10 to 30 minutes, and you might be asked to fill out a questionnaire to help your doctor assess your fracture risk.

What to Expect During and After the Procedure

Bone density tests are quick and painless. While routine evaluations are typically required every two years to observe significant changes in bone mineral density, some patients on high-dose steroid medication may require follow-ups every six months.

Who Interprets the Results and How Will You Receive Them?

A radiologist, trained in interpreting radiology examinations, will analyze the images and send a report to your primary care physician, who will discuss the results with you. The results will include two scores:

• T score: Compares your bone density to that of a healthy young adult. A score of -1 or higher is normal, while scores of -1.1 to -2.4 indicate osteopenia, and -2.5 or lower indicates osteoporosis.
• Z score: Compares your bone density with others in your age group. A low Z score may necessitate further medical evaluations.

Benefits vs. Risks

Benefits:

• DEXA scans are quick, simple, and noninvasive.
• The radiation dose is very low, significantly less than that of a standard chest x-ray.
• They are the most standardized method for diagnosing osteoporosis and assessing fracture risk.
• DEXA scans are widely available.

Risks:

• There is a minimal risk of cancer from radiation exposure; however, the benefits of accurate diagnosis greatly outweigh this risk.
• Pregnant women should always inform their doctor to minimize radiation exposure to the fetus.

Limitations of a Bone Density Scan

While DEXA scans provide valuable information, they cannot predict fractures definitively. They are also less effective for individuals with spinal deformities or those who haveundergone spinal surgery, as such conditions may affect accuracy. Central DXA devices offer better sensitivity and standardization than peripheral devices but are more expensive. It’s crucial for follow-up scans to be performed at the same facility using the same equipment, as measurements obtained from different devices cannot be directly compared.

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Key Benefits:

• Access to a Wide Range of Opportunities: MedicsPro offers a broad selection of locum and permanent positions across various medical specialties.
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• Flexible Work Options: With locum and permanent roles available, you can choose work that suits your schedule and lifestyle, offering greater work-life balance.
• Dedicated Support: MedicsPro offers personalised support from a team of experienced recruitment consultants who are there to guide you through the job search process.
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• Fast and Efficient Recruitment Process: MedicsPro ensures a smooth and streamlined recruitment process, minimising the time it takes for you to secure your next role.
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