DEXA scan patient guide

Overview

A DEXA scan (dual-energy X-ray absorptiometry) is a painless test that measures your bone density — how strong and thick your bones are. It uses a very low dose of X-rays to check the mineral content in your bones, most often the hip and lower spine.

Yes, DEXA scans are a standard test used worldwide to assess bone health, especially in people over 50 or those with risk factors for osteoporosis.

People who are at risk of osteoporosis, including postmenopausal women, men over 70, people on long-term steroid medications, and anyone who has had a low-trauma fracture (a break from a minor fall).

Symptoms

Common symptoms

• A DEXA scan itself has no symptoms — it is a test. However, you might be referred for a DEXA scan if you have had a fracture from a minor bump or fall, or if you have lost height over time.
• Other reasons include early menopause, long-term use of certain medicines (like steroids), or conditions that affect bone strength.

Symptoms in children

• Children rarely need a DEXA scan. If a doctor orders one, it may be because of a chronic illness or treatment that affects bone development. The scan is safe and adjusted for smaller bodies.

Symptoms in older adults

• In older adults, a DEXA scan is common to check for osteoporosis after a fracture, unexplained back pain, or a loss of height (which can signal spinal fractures).

Causes

Main causes

• A DEXA scan is not caused by anything—it is a test. The conditions it helps diagnose (like osteoporosis) are caused by bone loss as we age, especially after menopause in women, or by other medical problems.

Risk factors

• Being over age 50, especially women after menopause.
• Family history of osteoporosis or hip fracture.
• Low body weight or a small frame.
• Long-term use of corticosteroid medications.
• Smoking or heavy alcohol use.
• Low calcium or vitamin D intake.
• Certain conditions like rheumatoid arthritis, thyroid disorders, or eating disorders.

When to see a doctor

See a doctor urgently if:

• If you have a sudden, sharp back pain or a fracture from a minor fall, seek same-day medical care or go to urgent care.

Book a routine appointment if:

• Discuss with your doctor if you have risk factors for osteoporosis and have never had a DEXA scan. Women should usually start screening at age 65, or earlier if at high risk.
• Men over 70 or those with risk factors should also consider a discussion about bone health screening.

Diagnosis

A DEXA scan is performed by a trained technician. You lie on a padded table while a scanning arm passes over your body. The results are given as a T-score that compares your bone density to that of a healthy young adult.

Tests that may be done

• DEXA scan (dual-energy X-ray absorptiometry) of the hip and lower spine.
• Sometimes a forearm scan is done if the hip or spine cannot be measured.

What to expect at your appointment

You do not need to undress completely, but you should wear loose clothing without metal zippers or buttons. The scan is painless and takes about 15 minutes. You will be asked to lie still. After the scan, a radiologist reviews the images and sends a report to your doctor.

Treatment

A DEXA scan itself does not require treatment. The results guide your doctor to recommend steps to protect your bones. If you are found to have low bone density (osteopenia) or osteoporosis, treatment focuses on strengthening bones and preventing falls and fractures.

Self-care at home

• Eat a balanced diet rich in calcium (dairy, leafy greens, almonds) and vitamin D (sunlight, fatty fish, fortified foods).
• Do weight-bearing exercises like walking, dancing, or stair climbing at least 30 minutes most days.
• Avoid smoking and limit alcohol to no more than one drink per day for women, two for men.
• Prevent falls by keeping your home well-lit, removing tripping hazards, and using a walking aid if needed.

Medical treatments

If your DEXA results show osteoporosis, your doctor may recommend medications that help slow bone loss or build new bone. These are taken as pills, injections, or infusions. Your doctor will discuss the best option for you based on your age, risk factors, and any other health conditions. Never start or change a medication without medical advice.

When is surgery considered?

Surgery is not a treatment for osteoporosis itself, but if you have a hip or spinal fracture due to weak bones, surgery may be needed to repair the break. Your orthopedic surgeon will explain the options.

Living with this condition

After a DEXA scan, most people continue with normal activities. If you are diagnosed with low bone density, work with your doctor to create a bone health plan. Follow-up scans may be recommended every 1-2 years to track changes.

Lifestyle tips

• Stay active with weight-bearing and muscle-strengthening exercises.
• Eat bone-healthy foods and get enough vitamin D.
• Avoid smoking and excessive alcohol.
• Use good posture and lift safely to protect your spine.
• Consider a home safety check to prevent falls.

Diet and exercise

Aim for about 700-1200 mg of calcium per day from food (dairy, fortified plant milks, tofu, broccoli) and 10-20 micrograms (600-800 IU) of vitamin D. Exercises like brisk walking, jogging, tennis, and resistance training help maintain bone strength. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Being told you have low bone density can feel worrying, but it is very manageable. Many people live full, active lives by following their treatment plan. Talk to your doctor or a counsellor if you feel anxious or depressed about your bone health.

Prevention

While you cannot completely prevent age-related bone loss, you can significantly reduce your risk of osteoporosis and fractures by adopting healthy habits early. Getting enough calcium and vitamin D, staying active, and avoiding smoking and heavy drinking all help.

Vaccines

Omit

Screening programmes

A DEXA scan is the screening test for osteoporosis. Current guidelines recommend that women aged 65 and older have a screening DEXA scan. If you have risk factors, your doctor may recommend earlier or more frequent screening. Men at high risk should also discuss screening.

Complications

If left untreated

• Fractures from minor falls or bumps, especially of the hip, wrist, or spine.
• Chronic pain and loss of height from spinal fractures.
• Difficulty with daily activities and independence due to broken bones.

Long-term outlook

The great news is that osteoporosis is treatable. With early detection by DEXA scan and a good treatment plan, most people can avoid serious fractures and maintain an active, independent life. Your bone health is something you can improve at any age.

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