Unlock Bone Health: Your DXA Scan Guide

I remember a patient, let’s call her Eleanor. She’d just had her 67th birthday and came in saying, “Doc, I tripped on the rug the other day. Nothing broken, thank goodness, but it got me thinking… am I getting brittle?” It’s a thought many of us have as we get a bit older, and it often leads us to a conversation about bone health, and sometimes, about something called a DXA scan.

It’s a common concern, that feeling of not being as sturdy as we once were. And that’s exactly why tools like the DXA scan are so helpful.

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So, What Exactly is a DXA Scan?

Alright, let’s break it down. A DXA scan – and you might hear it called a bone density test – is basically a special kind of X-ray. The “DXA” part stands for dual-energy X-ray absorptiometry. Sounds a bit complicated, I know, but all it means is that it uses two X-ray beams with different energy levels to give us a really good picture of how strong, or dense, your bones are.

We used to call them DEXA scans, with an ‘E’, but that’s an older term we don’t use much anymore. The important thing is what it tells us.

This scan helps us figure out a few key things:

It can diagnose osteoporosis, a condition where bones become weak and more likely to break.
It can also spot osteopenia, which is like a warning sign – your bone density is lower than normal, but not yet at the osteoporosis stage.
And, it helps us understand your risk of a bone fracture down the line.

Sometimes, we also use a DXA scan to see how your bones are doing over time. Maybe we’re tracking natural bone loss that happens with age, or checking if a medication for bone health is doing its job.

When Might We Talk About a DXA Scan?

Now, you might be thinking, “Do I need one of these?” Good question! We don’t just send everyone for a DXA scan. It’s something we consider based on a few things. We generally recommend it for:

Women over 65.
Men over 70.
Anyone over 50 who’s unfortunately broken a bone.
If you have a family history – say, your parents or grandparents had osteoporosis.
If you’ve noticed you’re shorter than you used to be, maybe by an inch and a half or more from your tallest height (usually in your 20s).

Sometimes, even if you’re younger, certain things can increase your risk of bone loss, and we might suggest a scan. These can include:

Having certain autoimmune diseases.
Smoking or using tobacco products.
Drinking a lot of alcohol regularly.
Not getting enough Vitamin D.
Taking certain medications long-term, like corticosteroids, some cancer treatments, or even some drugs for acid reflux (like proton pump inhibitors).

If any of these sound like you, it’s worth a chat. We’ll figure out if a DXA scan is the next best step.

What’s the DXA Scan Experience Like?

The best part? It’s usually a pretty simple and painless process.

Getting Ready for Your Scan

You generally don’t need to do much out of the ordinary.

You can usually eat and drink normally beforehand.
Take your usual medications, unless I specifically tell you otherwise.
One thing to hold off on: if you take calcium supplements or other over-the-counter vitamins, it’s best to skip them for 24 hours before your test. Just let me know what you take.
Wear comfy, loose clothes. Try to avoid anything with metal zippers, buttons, or big buckles, as you might need to remove them.

Oh, and if you’ve had other imaging tests with contrast dye recently (like a CT scan or nuclear medicine scan), let the scheduling folks know. We might need to time your DXA scan a bit differently.

During the Scan

This isn’t like an MRI where you’re in a tight tube. Not at all.

You’ll lie down on a padded table. It’s an outpatient thing, so no hospital stay.
A radiologic technologist – that’s the skilled person who runs the machine – will help you get into the right position. They might use some soft foam blocks to keep your legs comfy and still.
Then, a scanner arm will pass slowly over your body. It’s not touching you, just taking pictures. We usually look at your hips and spine, as these are common spots for bone density changes, but sometimes we might scan your forearm too.
The whole thing typically takes about 10 to 30 minutes. Quick and easy.

The machine uses very low levels of X-rays. Your bones show up as white in the images, while softer tissues are like shadows.

Understanding Your DXA Scan Results

After your scan, we’ll get a report with something called a T-score. It sounds a bit technical, but it’s just a way to compare your bone density to that of an average, healthy young adult (when bones are typically at their strongest).

Here’s a general idea of what those T-scores mean:

A T-score between +1 and -1: This is generally considered normal, healthy bone density. Great news!
A T-score between -1 and -2.5: This usually indicates osteopenia. Your bones are less dense than normal, and you might have a higher risk of osteoporosis later. It’s a good time to be proactive.
A T-score of -2.5 or lower: This typically means you have osteoporosis. Your bones are weaker, and your risk of fracture is higher.

Don’t worry about memorizing these numbers. I’ll go over your specific results with you, and we’ll talk about what they mean for you. If your bone density is lower than we’d like, there’s a lot we can do:

Getting more active: Things like walking, yoga, or light strength training can really help your bones.
Diet and supplements: We might talk about getting more calcium and vitamin D, either through foods or supplements.
Medication: If needed, there are medications that can help slow down bone loss or even build new bone.

We’ll explore all the options together.

Are There Any Downsides?

Honestly, there are very few risks with a DXA scan. You won’t feel any pain during or after. The amount of radiation is super low – even lower than a standard chest X-ray, and less than you’d get on a long airplane flight.

The main thing is, if you’re pregnant or think you might be, we need to know. We generally avoid all X-rays during pregnancy if possible, even low-dose ones like this.

DXA Scan vs. Whole-Body Bone Scan: What’s the Difference?

This question comes up sometimes. While both are “bone scans,” they look for different things.

A DXA scan, as we’ve discussed, is all about measuring your bone density to check for things like osteoporosis.
A whole-body bone scan (often a nuclear medicine scan) is different. We might use that if we’re concerned that cancer has spread to the bones, or to look for bone infections or other specific lesions. It’s a different tool for different questions.

Your Bone Health: Key Takeaways from Our Chat

Thinking about your bones is a smart move, especially as the years go by. Here’s what I really want you to remember about the DXA scan:

It’s a simple, painless X-ray test to measure your bone density.
It helps us spot osteopenia and osteoporosis early.
We usually recommend it based on age, risk factors, or a previous fracture.
Preparation is minimal – just hold off on calcium supplements the day before.
Your results, given as a T-score, help us understand your bone strength and fracture risk.
If your bone density is low, we have good ways to help protect your bones.

You’re not alone in thinking about this. So many of my patients have these same questions. Taking steps to understand and protect your bone health is a great way to keep yourself active and feeling good for years to come. If you have any worries, let’s talk.