- Diseases associated with:
- Immobilization
- Malabsorption
- Inflammation
- Gonadal hormone imbalance
- High-risk medications:
- Vitamin D deficiency
- Obesity
- Malnutrition not due to eating disorder or chronic disease
Obtain DXA Scan
Consider DXA Scan
DXA Scan NOT Indicated
Before ordering a DXA scan, use clinical judgement to
consider how the results will change patient care
Imaging Recommendations |
Patient Age |
3 - 18 yrs |
≥ 18 yrs |
Standard Scan Sites |
Lumbar Whole body |
Lumbar
Whole body
Hip |
Alternative Scan Sites If spinal disease, hardware, positional challenges |
5 - 18 yrs
|
Lateral Distal Femur |
Distal Forearm
Lateral Distal Femur
|
Z-score ≤ -2
Low Bone Mineral Density
Z-score > -2 up to +2
Normal Bone Mineral Density
- Factors interfering with accurate interpretation:
- Barium studies in the
7 days prior DXA scan
- Contrast materials within the
last 7 days
- Calcium supplements within the
last 24 hours
- Other Ordering Considerations
- Spinal disease or positional challenges
- Hardware in scan sites
- Ventilator dependence
Presence of
- Primary Bone Disorder
- Clinically Significant Fractures
Absence of
- Primary Bone Disorder
- Clinically Significant Fractures
Reassess bone mineral density
if clinical situation changes
Referral to Bone Health Specialist
Treatment, DXA scan monitoring as indicated per specialist recommendations
Posted: September 2018
Authors: Mascarenhas, M. MD; Webster, J. MD; Barsky, D. MD; Jannelli, F. RN; Calabria, A. MD; Downing, M. MHA