Preparing for DEXA scan

Overview

A DEXA scan (dual-energy X-ray absorptiometry) is a quick, painless test that measures the strength and density of your bones. It is like taking a picture of your bones to see if they are healthy or becoming weak and brittle — a condition called osteoporosis.

DEXA scans are commonly done for people over 50, especially women after menopause, and for anyone with risk factors for bone loss.

People who have had a fragility fracture, are on long-term steroid medication, have early menopause, or have a family history of osteoporosis.

Symptoms

Common symptoms

• Often, osteoporosis has no symptoms until a bone breaks.
• Back pain caused by a collapsed vertebra (spinal bone).
• Loss of height over time.
• A stooped posture.

Symptoms in children

• Children rarely need a DEXA scan unless they have a condition that affects bone health, such as juvenile arthritis or long-term steroid use.
• In children, symptoms may include bone pain, fractures from minor falls, or delayed growth.

Symptoms in older adults

• Older adults may notice a gradual loss of height, a curved spine, or fractures that happen easily.
• They often have no symptoms until a fall causes a broken hip, wrist, or spine.

Causes

Main causes

• Osteoporosis occurs when bone tissue breaks down faster than your body can replace it.
• Common causes include aging, hormonal changes (especially lower estrogen after menopause), and certain medications.

Risk factors

• Being over 50.
• Being female, especially after menopause.
• Low body weight or a small frame.
• Family history of osteoporosis or hip fracture.
• Smoking or heavy alcohol use.
• Long-term use of steroid medicines (glucocorticoids).
• Low calcium and vitamin D intake.

When to see a doctor

See a doctor urgently if:

• If you break a bone from a minor fall or bump — this may be a fragility fracture.
• If you have sudden, severe back pain that does not improve with rest.

Book a routine appointment if:

• All women aged 65 and older should be screened for osteoporosis.
• Men aged 70 and older, or anyone with risk factors, should talk to their doctor about a DEXA scan.
• If you are on long-term steroids, ask your doctor about bone density testing.

Diagnosis

Osteoporosis is diagnosed using a DEXA scan that measures your bone mineral density (BMD). The results are given as a 'T-score' which compares your bone density to that of a healthy young adult.

Tests that may be done

• DEXA scan (central dual-energy X-ray absorptiometry) of the hip and spine.
• Peripheral DEXA may test the wrist, heel, or finger.
• Your doctor may also order blood tests to rule out other causes of bone loss.

What to expect at your appointment

Before the scan, avoid taking calcium supplements for 24 hours. Wear loose, comfortable clothing without metal zippers or buttons. The test is painless: you lie on a padded table while a scanner arm passes over your body. You will be asked to hold still for a few seconds. Afterwards, you can resume normal activities immediately.

Treatment

Treatment for osteoporosis focuses on slowing bone loss, increasing bone density, and preventing fractures. Your doctor will recommend a plan based on your age, risk factors, and DEXA results.

Self-care at home

• Get enough calcium and vitamin D through diet or supplements — ask your doctor how much you need.
• Do weight-bearing exercises such as walking, dancing, or climbing stairs.
• Do muscle-strengthening exercises like lifting light weights or using resistance bands.
• Avoid smoking and limit alcohol to 2 drinks or less per day.
• Take steps to prevent falls: remove trip hazards, use handrails, and wear sturdy shoes.

Medical treatments

Your doctor may prescribe medications that help slow down bone loss or increase bone formation. These are usually taken as pills, injections, or infusions. Always discuss the benefits and side effects with your healthcare provider before starting any treatment.

When is surgery considered?

Surgery is rarely needed for osteoporosis itself, but it may be necessary to repair a broken bone, such as a hip fracture. In such cases, an orthopedic surgeon will discuss the best options.

Living with this condition

If you have osteoporosis, you can still live an active, full life. The key is to protect your bones and prevent falls. Learn proper body mechanics for lifting and bending, and keep your home well-lit and clutter-free.

Lifestyle tips

• Stay physically active with safe, low-impact activities like swimming or tai chi.
• Eat a bone-healthy diet rich in calcium (dairy, leafy greens, almonds) and vitamin D (fatty fish, fortified milk).
• Get enough sunlight for vitamin D, but with sun protection.
• Talk to your doctor about fall-prevention strategies, especially if you have balance issues.

Diet and exercise

Aim for 1,000 to 1,200 mg of calcium daily from food or supplements, and 600 to 800 IU of vitamin D. Combine weight-bearing exercise (like brisk walking) with strength training (like leg presses or bicep curls).

Mental health and emotional wellbeing

Living with a chronic condition like osteoporosis can lead to worry about fractures and loss of independence. It is normal to feel anxious or sad. If these feelings persist, talk to your doctor or a mental health professional. Remember, you are not alone — support is available.

Prevention

While you cannot control all risk factors, you can build strong bones at any age. Eating a calcium-rich diet, getting enough vitamin D, exercising regularly, and avoiding smoking and excessive alcohol can help prevent osteoporosis. Falls can be prevented with simple home modifications.

Screening programmes

The NHS recommends a DEXA scan for women aged 65 and older, and for younger people with risk factors. Talk to your doctor about when you should be screened.

Complications

If left untreated

• Untreated osteoporosis increases your risk of fractures, especially in the hip, spine, and wrist.
• Spinal fractures can cause chronic back pain and a hunched posture (kyphosis).
• A hip fracture often requires surgery and can lead to loss of mobility and independence.

Long-term outlook

With early detection and proper management, many people with osteoporosis can prevent fractures and maintain an active lifestyle. New treatments and lifestyle changes can significantly improve bone health. Your outlook is brighter when you take proactive steps and work with your healthcare team.

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