Bone Density Scan (DEXA)

A DEXA (dual-energy X-ray absorptiometry) scan measures bone mineral density to assess osteoporosis risk and fracture probability. It uses very low-dose X-rays and is the gold standard for bone density measurement. The scan is quick, painless, and widely available.

DEXA is recommended for all women 65+ and men 70+, postmenopausal women under 65 with risk factors, anyone with a fragility fracture, patients on long-term corticosteroids, and to monitor osteoporosis treatment effectiveness.

No fasting is required. Avoid calcium supplements for 24 hours before the test. Wear loose, comfortable clothing without metal. Inform your doctor if you recently had a barium study or contrast injection.

You lie on a padded table while a scanning arm passes over your body, typically measuring the hip and lumbar spine. You remain clothed. The scan takes 10-20 minutes and is completely painless. Radiation exposure is minimal — less than a chest X-ray.

No recovery needed. Resume all normal activities immediately. Results are provided as a T-score comparing your bone density to a healthy young adult. T-score above -1 is normal, -1 to -2.5 is osteopenia, and below -2.5 indicates osteoporosis.

DEXA is extremely safe. Radiation exposure is minimal (about 0.001 mSv, equivalent to a few hours of natural background radiation). There are essentially no risks from the procedure itself.

Alternatives include quantitative CT (qCT), quantitative ultrasound of the heel, and FRAX score calculation (fracture risk assessment without imaging). However, DEXA remains the standard for diagnosis and monitoring.

Medicare covers DEXA every 2 years for qualifying women (65+ or with risk factors). Most insurance plans cover screening per USPSTF guidelines. Follow-up scans for monitoring treatment are also covered.