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Bone density screening decisions (who needs DEXA)
Category: Screening Tests · All screening tests
What it is
Osteoporosis screening is not a universal programme; instead, fracture risk is assessed clinically (for example with the FRAX tool, combining age, weight, previous fractures, steroids, smoking, alcohol and family history) and a DEXA scan is arranged when the result would change treatment decisions.
Why it is done
Finding low bone density or high fracture risk before a fragility fracture allows bone-protective treatment, falls prevention and lifestyle measures that reduce fractures — particularly hip fractures, which carry serious consequences in older adults.
How to prepare
Bring a list of medicines (especially steroids and hormone treatments), previous fracture history and height/weight. Tell the radiographer about recent barium studies or nuclear scans, which can interfere, and about hip replacements or spinal surgery, which affect measurement sites.
What happens during the procedure
The DEXA itself takes about 10 to 20 minutes lying still while a low-dose scanner arm passes over the hip and spine. Risk assessment happens in clinic using your history, with or without the scan result.
Afterwards — recovery & results
Results (T-scores and fracture risk estimates) are explained by your clinic: lifestyle measures for all, calcium/vitamin D checks, and bone-protective medicines when risk is high enough. Repeat scans are usually spaced years apart, as bone changes slowly.
Risks & considerations
DEXA radiation is extremely low. The main programme-level harm is treating people at low risk unnecessarily — which careful risk assessment avoids. Conversely, a fragility fracture itself is an indication for assessment even without prior screening.
Related guides on MedicalVideos.com
Frequently asked questions
I broke my wrist in a fall from standing height — why no scan yet?
A fragility fracture like that is itself strong evidence — many guidelines treat or assess immediately. Chase your clinic if no bone health assessment followed your fracture.
Can I just buy a private DEXA?
You can, but the number needs clinical context (FRAX factors, blood tests for secondary causes) to guide treatment. Discuss with your doctor first so the result is acted on properly.
Related procedures — Screening Tests
Browse the B section of the A–Z list or return to the Procedures & Tests hub.