Outpatient Specialty Care and Primary Care Clinical Pathway for Children
Who May Need a Dual Energy X-ray Absorptiometry (DXA) Bone Density Scan
Related Pathways
- Vitamin D deficiency
- Obesity
- Mild Malnutrition
- Diseases associated with:
- Immobilization
- Malabsorption
- Inflammation
- Gonadal hormone imbalance
- High-Risk Medications
- Primary Bone Disorders
- Clinically Significant Fractures
- Previous abnormal DXA scan
DXA scan not indicated
DXA Scan Interpretation
Find results in EHR within DXA Encounter
Find results in EHR within DXA Encounter
| DXA Scan Sites | ||
|---|---|---|
| Age | Standard Scan Sites | Alternative Scan Sites |
| 1-2 yrs | Lumbar | Forearm |
| ≥ 3-4 yrs | Lumbar Whole body |
Forearm |
| ≥ 5-17 yrs | Lumbar Whole body |
Hip Forearm Lateral distal femur |
| ≥ 18 yrs | Lumbar Hip |
Forearm Whole body |
Z-score > -2 to 2
Bone density within expected reference range
Bone density within expected reference range
Z-score ≤ -2
Low bone mineral density
Low bone mineral density
Absence of primary bone disorder and/or known risk factors for impaired bone health
Presence of primary bone disorder and/or known risk factors for impaired bone health
Absence of primary bone disorder and/or clinically significant fractures
Presence of primary bone disorder and/or clinically significant fractures
Reassess bone mineral density if clinical situation changes
- Z-score > -2 does not rule out impaired bone health
- Consider referral to Center for Bone Health, for further testing, and/or repeat DXA scan if:
- Prior history of and/or new minimally traumatic long bone or spine fractures
- Condition where recovery
is not expected - Ongoing and/or additional exposure to bone toxic medications
- Optimize treatment and management of underlying disease
- Repeat DXA scan as clinically indicated per guidance by body system or
DXA scan interpretation - Consider referral to
Center for Bone Health
- Refer to Center for Bone Health
- Treatment and DXA scan monitoring as indicated per specialist recommendations