Bone Density Scan (DXA) Clinical Pathway — Outpatient Specialty Care and Primary Care
Bone Density Scan (DXA) Clinical Pathway — Outpatient Specialty Care and Primary Care
DXA Scan Interpretation
A DXA Scan alone is not adequate to diagnose osteopenia or osteoporosis in children. Clinical information including history of significant fracture, family history, BMI, Tanner stage, and laboratory values should be correlated with DXA results for appropriate interpretation.
The Z-score compares the child’s results to the average bone density of people of the same age, sex and race. The results will further guide the level of concern about bone density abnormalities and what interventions the clinician should consider for continued management.
Factors Interfering with Accurate Interpretation
| Barium Studies or Contrast | Within the last 7 days |
|---|---|
| Calcium Supplementation | Within the last 24 hrs |
| Spinal Disease | e.g., severe scoliosis |
| Severe Spasticity | e.g., cerebral palsy with contractures |
| Hardware in Scan Sites | e.g., spinal rods, feeding tubes, pacemaker |
| Positional Challenges | e.g., inability to lie still or due to developmental delays |
| Short or Tall Stature | DXA scan result is adjusted if the patient's height is < 5th percentile or > 95th percentile |