Dexa scan

Overview

A DEXA scan (also called a bone density scan) is a quick, painless X-ray test that measures how strong your bones are. It is used to check for bone thinning or osteoporosis, a condition that makes bones more likely to break.

Yes, DEXA scans are a common test, especially for adults over 50 or those with risk factors for bone loss.

DEXA scans are recommended for people at higher risk of osteoporosis, including women after menopause, men over 70, and anyone who has had a fragility fracture (a bone break from a minor fall). It can also be used to monitor bone density over time.

Symptoms

Common symptoms

• DEXA scans themselves are not a disease – they are a test. But they are used to detect low bone density, which often has no symptoms until a bone breaks.

Symptoms in children

• DEXA scans are rarely needed in children, but may be used if a child has a condition that affects bone health, like long-term steroid use or eating disorders.

Symptoms in older adults

• Older adults may have no symptoms of bone loss, but a DEXA scan can reveal if bones are fragile before a fracture happens.
• Some signs that might prompt a DEXA scan include loss of height, a stooped posture, or a broken bone after a minor bump.

Causes

Main causes

• Low bone density itself is not a disease, but it can be caused by aging, hormonal changes (especially after menopause), and long-term use of certain medications like steroids.
• Other causes include low body weight, smoking, heavy alcohol use, and a diet low in calcium and vitamin D.

Risk factors

• Being female, especially after menopause
• Being over 70 years old
• Having a parent who broke a hip
• Having a body mass index (BMI) below 19
• Long-term use of corticosteroid tablets (e.g., prednisolone)
• Smoking or drinking more than 2 units of alcohol per day
• Conditions like rheumatoid arthritis, coeliac disease, or an overactive thyroid

When to see a doctor

See a doctor urgently if:

• If you have broken a bone from a very minor fall or bump, see your GP or go to a fracture clinic. You may need a DEXA scan and treatment to prevent further fractures.

Book a routine appointment if:

• If you are over 50 and have any risk factors for osteoporosis, talk to your GP about whether a DEXA scan is right for you.
• Women should discuss bone health with their doctor around the time of menopause.

Diagnosis

A DEXA scan is the main diagnostic tool. It measures bone mineral density (BMD) in your hip and lower spine. Results are given as a T-score: -1.0 or above is normal, between -1.0 and -2.5 means low bone density (osteopenia), and -2.5 or lower means osteoporosis.

Tests that may be done

• DEXA scan (central – hip and spine)
• Sometimes a peripheral DEXA scan (wrist or heel) is used for initial screening.
• Your doctor may also order blood tests to rule out other causes of bone loss.

What to expect at your appointment

You lie on a padded table while a scanning arm passes over your body. You need to lie still for a few minutes. No special preparation is needed, but avoid taking calcium supplements for 24 hours before the scan. The test is painless and takes about 10 to 20 minutes.

Treatment

Treatment after a DEXA scan depends on your T-score and overall fracture risk. It may include lifestyle changes and, if needed, medication to strengthen bones and reduce break risk.

Self-care at home

• Make sure you get enough calcium and vitamin D from diet or supplements (take advice from your doctor or pharmacist).
• Do weight-bearing and resistance exercises (like walking, jogging, or lifting light weights).
• Stop smoking and limit alcohol.
• Prevent falls by keeping your home safe and having your eyesight checked.

Medical treatments

If your fracture risk is high, your doctor may prescribe a type of medicine called bisphosphonates, or other bone-strengthening medicines. These are usually taken as tablets or given as an injection. Your doctor will explain the options, benefits, and possible side effects. Never start or stop any medication without talking to your healthcare provider.

When is surgery considered?

Surgery is not a treatment for low bone density itself, but it may be needed to repair a broken bone, such as a hip fracture.

Living with this condition

If you have osteoporosis or low bone density, you can still lead an active life. Focus on fall prevention and bone-friendly habits. Talk to your doctor about safe ways to exercise.

Lifestyle tips

• Eat a balanced diet rich in calcium (dairy, leafy greens, almonds) and vitamin D (oily fish, eggs, fortified foods).
• Try to get 10–20 minutes of sunlight exposure on your skin each day (if possible) to help your body make vitamin D.
• Avoid hunching or heavy lifting that puts strain on your spine.
• Use handrails, non-slip mats, and good lighting at home to reduce fall risk.

Diet and exercise

Aim for at least 150 minutes of moderate activity per week, including weight-bearing exercises (e.g., brisk walking, dancing, tennis) and resistance exercises (e.g., using light weights or resistance bands). This helps keep bones and muscles strong.

Mental health and emotional wellbeing

Being told you have low bone density can be worrying, but remember it is very treatable. Many people live well with osteoporosis. If you feel anxious or down, talk to your doctor or a counsellor. You are not alone.

Prevention

You cannot always prevent bone loss, but you can reduce your risk. A healthy lifestyle throughout life builds strong bones. After menopause or as you age, taking steps to slow bone loss is key.

Vaccines

There are no vaccines for osteoporosis. However, staying up to date with flu and pneumonia vaccines can help you avoid illnesses that might cause falls or inactivity.

Screening programmes

Screening with a DEXA scan is not routinely offered to everyone, but it is available if you have risk factors. The UK NHS offers a fracture risk assessment (FRAX) tool that your doctor can use to decide if a DEXA scan is right for you.

Complications

If left untreated

• Increased risk of broken bones (fractures), especially in the hip, wrist, or spine.
• Loss of height and a stooped posture (called kyphosis).
• Chronic back pain from spinal fractures.
• Difficulty with daily activities and reduced mobility after a fracture.

Long-term outlook

The outlook for people with low bone density is very good. With early diagnosis and proper treatment, you can reduce your fracture risk and continue to live an active, full life. Most treatments are effective and well-tolerated.

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