DEXA scan Q&As
Published by Bupa's health information team, September 2009.
Answers to questions about DEXA scan
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- I'm a 79-year-old woman and broke my wrist in a recent fall. Do I need to have a DEXA scan?
- What will happen if I'm classed as having osteopenia?
- Will I have a repeat DEXA scan to check if my treatment is working?
- Will a scan on my heel show whether I have osteoporosis?
I'm a 79-year-old woman and broke my wrist in a recent fall. Do I need to have a DEXA scan?
No, a scan probably isn't necessary. You may need to consider starting treatment to help prevent any further fractures.
Explanation
DEXA scans help doctors to spot the people who are at high risk of osteoporosis and who could benefit from treatment to prevent fractures. If you're over 75, you're at an increased risk of osteoporosis. Your wrist fracture shows that you already have fragile bones. Speak to your GP for more advice and information about starting this treatment.
Sources
- Osteoporosis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 19 February 2009
What will happen if I'm classed as having osteopenia?
Your GP will probably advise you to make some lifestyle changes if you're diagnosed with osteopenia after having a DEXA scan.
Explanation
Having osteopenia means you have a lower bone density than normal and could be at risk of developing osteoporosis. If you're given a diagnosis of osteopenia after your DEXA scan, your doctor will probably suggest you make some lifestyle changes. This is to slow down the possible progression to osteoporosis and therefore reduce your risk of breaking a bone. Your doctor may recommend the following lifestyle changes.
- Include more calcium in your diet. Foods that are high in calcium include milk, hard cheese, yoghurt, sardines and white bread. Your doctor may advise you to take vitamin D supplements, as vitamin D helps calcium to be absorbed into the body.
- Carry out regular, low-impact, weight-bearing exercise, such as walking.
- If you smoke, try to stop.
- Don't drink too much alcohol.
You won't usually be prescribed medicine if your bone density isn't low enough for you to be diagnosed with osteoporosis. However, you may be advised to have another scan two to five years later to check on your progress.
Further information
- National Osteoporosis Society
0845 450 0230
www.nos.org.uk
Sources
- Osteoporosis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 19 February 2009
- Scans and tests and osteoporosis. National Osteoporosis Society. www.nos.org.uk, accessed 18 February 2009
Will I have a repeat DEXA scan to check if my treatment is working?
You will usually only need to have another scan if you break a bone (after only a minor bump or fall), despite having been on treatment for at least two years.
Explanation
If you haven't broken any bones while taking treatment for osteoporosis, this is thought to be enough evidence that your treatment is working well. It's not usually necessary to have another DEXA scan just to check up on your progress.
However, if you do break a bone after you have been taking treatment for osteoporosis for at least two years, you may be advised to have a repeat scan. You won't usually be offered a scan if you break a bone and have been on treatment for less time than this as it can take up to two years for the treatment to have a beneficial effect on your bones. If a repeat scan shows that your bone mineral density is still below normal, your doctor may suggest trying another type of treatment.
If you feel that you would like a repeat scan and you're not entitled to one on the NHS in your area, it's sometimes possible to arrange to have one privately. However, you will still usually need to be referred by your GP.
Sources
- Osteoporosis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 19 February 2009
- Scans and tests and osteoporosis. National Osteoporosis Society. www.nos.org.uk, accessed 18 February 2009
Will a scan on my heel show whether I have osteoporosis?
No, a DEXA scan carried out on your heel can't diagnose osteoporosis. This is because the bone density in your heel isn't always a good indication of the density in your other bones.
Explanation
A scan of your hip and spine is currently considered to be the most reliable method (the 'gold standard') for diagnosing osteoporosis and predicting the risk of fractures. This is partly because international statistics that enable your risk of fractures to be worked out are based on scans of only these bones. Also, a fractured hip is one of the most serious consequences of osteoporosis and the best way to predict it is to scan the hip rather than any other bone.
Alternative scanners are available that can measure the bone density of your heel and other bones including those in your forearm, finger and hand. These are known as peripheral scans and are sometimes used as screening to see who may need further investigations.
Although peripheral scans might give an accurate measure of bone density at the part of your body that is tested, researchers aren't sure how good they are at predicting your risk of fractures. If you have a peripheral scan that shows low bone density, you're likely to need a hip and spine DEXA to confirm the findings.
The National Institute for Health and Clinical Excellence (NICE) is working on guidance on the best way to screen for osteoporosis. Until this is published, follow your GP's advice and get your DEXA scan done at a clinic that carries out the conventional spine and hip measurements.
Further information
- National Osteoporosis Society
0845 450 0230
www.nos.org.uk - National Institute for Health and Clinical Excellence (NICE)
www.nice.org.uk
Sources
- Management of osteoporosis. Scottish Intercollegiate Guidelines Network (SIGN), June 2003. www.sign.ac.uk
- Osteoporosis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 19 February 2009
- Scans and tests and osteoporosis. National Osteoporosis Society. www.nos.org.uk, accessed 18 February 2009
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: September 2009
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