A bone density scan, most commonly performed as a dual-energy X-ray absorptiometry (DEXA or DXA) scan, is a non-invasive test used to measure bone mineral density. The results help determine your risk of osteoporosis and bone fractures. While the procedure is safe, it is not administered to everyone. A patient's eligibility is carefully evaluated based on established medical guidelines and individual risk factors. Therefore, the answer to can anyone get a bone density scan is no, not everyone is a candidate for this diagnostic test. A healthcare provider makes the final decision based on a comprehensive assessment.
Standard eligibility guidelines for bone density scans
Medical and osteoporosis organizations have established clear guidelines for who should be screened with a bone density scan. These recommendations primarily target those at the highest risk of developing osteoporosis or related fractures.
Women
- All women aged 65 or older are recommended for routine screening.
- Postmenopausal women younger than 65 who have additional risk factors, such as low body weight, prior fracture, or high-risk medication use, should be considered for a scan.
- Women who recently went through menopause with specific risk factors for fracture.
Men
- All men aged 70 or older are typically recommended for screening.
- Men younger than 70 with risk factors for low bone mass, including low body weight, prior fracture, or high-risk medication use, may also be candidates.
Other high-risk adults
- Individuals over 50 who have experienced a fragility fracture—a fracture caused by minimal or no trauma.
- Adults with a disease or medical condition linked to bone loss, such as rheumatoid arthritis, chronic kidney disease, or liver disease.
- Individuals taking medications associated with low bone mass, including long-term corticosteroid use.
Medical conditions and lifestyle factors that increase risk
Beyond age and gender, several conditions and lifestyle choices significantly increase the risk of low bone density and fracture. A doctor will consider these factors when deciding on the necessity of a DEXA scan.
Medical conditions
- Rheumatoid arthritis
- Chronic kidney or liver disease
- Thyroid or parathyroid disorders
- Type 1 diabetes
- Celiac disease or other malabsorption syndromes
- Eating disorders
Medications and other treatments
- Long-term use of corticosteroids, such as prednisone
- Certain anti-seizure medications
- Medications for prostate or breast cancer
- Immunosuppressants
- Long-term use of proton-pump inhibitors for acid reflux
Lifestyle factors
- History of smoking or excessive alcohol consumption
- Low body weight or low body mass index (BMI)
- Significant loss of height
- Family history of osteoporosis
- Prolonged periods of immobility or physical inactivity
Medical vs. wellness DEXA scans: What's the difference?
It's important to distinguish between a medically necessary DEXA scan and a wellness scan. While both use the same technology, they serve different purposes and have different costs and coverage.
| Feature | Medical DEXA Scan | Wellness DEXA Scan |
|---|---|---|
| Purpose | Diagnosing or monitoring osteoporosis or other bone diseases. | Assessing body composition (fat, lean mass) and baseline bone health. |
| Initiated by | Physician's order based on medical necessity criteria. | Patient's request, often at a private wellness center. |
| Cost | Often covered by insurance, including Medicare, if criteria are met. | Typically not covered by insurance; paid out-of-pocket. |
| Coverage | Varies by insurance provider, but often requires specific risk factors or conditions. | Not covered by insurance. The patient bears the full cost. |
| Interpretation | Radiologist provides a T-score (compared to a healthy young adult) or Z-score (compared to peers) for medical diagnosis. | Report focuses on body composition analysis and general bone density measurements. |
What to expect during a DEXA scan
A DEXA scan is a quick and painless procedure. The patient lies on a padded table while a scanner moves slowly over the body. During the scan, which typically lasts about 15 to 20 minutes, they will be asked to remain still. To prepare, patients should avoid taking calcium supplements for at least 24 hours beforehand and wear loose, comfortable clothing without metal zippers, buttons, or buckles. The scan uses a very low dose of radiation, and experts agree the benefits of detecting bone loss outweigh the minimal risk.
How a doctor determines your need
Your healthcare provider will assess the information collected during your visit to determine if you need a bone density scan. This evaluation considers your age, gender, personal and family medical history, and any relevant lifestyle factors. In some cases, a doctor might use a fracture risk assessment tool (FRAX) in combination with a baseline bone density measurement to better predict your 10-year fracture risk. Based on this comprehensive evaluation, a physician can make an informed recommendation regarding a DEXA scan, ensuring that the test is used effectively and appropriately for each patient.
Conclusion
In short, the answer to the question "Can anyone get a bone density scan?" is no. These scans are not universally available but are a targeted diagnostic tool for individuals who meet specific criteria based on age, medical history, and risk factors. While anyone can seek a wellness scan for body composition, a medically justified DEXA scan requires a doctor's evaluation. By following established guidelines, healthcare professionals can ensure that those who truly need this important screening receive it, allowing for early detection and treatment of conditions like osteoporosis to improve bone health and prevent future fractures.
For more detailed information on osteoporosis prevention and management, including diet and exercise recommendations, you can consult reputable sources like the Bone Health and Osteoporosis Foundation(https://www.bonehealthandosteoporosis.org/).
