II. Indications: Osteoporosis Evaluation

  1. See Bone Mineral Density
  2. Gold standard Osteoporosis Screening and monitoring

III. Protocol: Sites for measuring bone mass

  1. Lumbar Vertebrae
    1. Assess risk of Vertebral Compression Fractures
    2. Screening younger patients without Osteoarthritis
  2. Femoral Neck
    1. Assess risk of Hip Fractures
    2. Screening older patients with Osteoarthritis
  3. Other locations
    1. Wrist
    2. Calcaneus
  4. References
    1. Cummings (1993) Lancet 341:72 [PubMed]
    2. Marshall (1996) BMJ 312:1254 [PubMed]

IV. Advantages

  1. Negligible radiation
  2. Accurate, reproducible predictor osteoporotic Fracture
  3. Excellent measure of treatment response

V. Disadvantages

  1. Moderate cost
  2. Osteoarthritis interferes with Spine DEXA Scan reading
    1. False elevated BMD on PA Spine views in elderly
    2. In elderly, use hip or lateral spine views

VI. Scoring

VII. Monitoring: Osteopenia and Osteoporosis

  1. Recheck DEXA Scan
    1. Normal or only mild Osteopenia of femoral neck: Recheck DEXA in 15 years
    2. Moderate Osteopenia: Recheck DEXA in 5 years
    3. Severe Osteopenia: Recheck DEXA Scan in 1 year
    4. Osteoporosis: Recheck DEXA every 2 years or less
    5. Gourlay (2012) N Engl J Med 366(3): 225-33 [PubMed]
  2. Monitoring for change
    1. Use absolute value in grams per cm^2 from now and prior DEXA Scan (not the T-Score)
    2. Use Least Significant Change defined for the particular scanner used
      1. Calculate the difference in absolute values (g/cm^2) between now and prior DEXA Scan
      2. Significant difference if change in absolute value exceeds Least Significant Change

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Ontology: Dual-Energy X-Ray Absorptiometry (C1510486)

Definition (NCI_NCI-GLOSS) An imaging test that measures bone density (the amount of bone mineral contained in a certain volume of bone) by passing x-rays with two different energy levels through the bone. It is used to diagnose osteoporosis (decrease in bone mass and density).
Definition (NCI) A technique for scanning bone and measuring bone mineral density (BMD). A DXA scanner produces 2 X-ray beams, each with different energy levels. One beam is high energy while the other is low energy. The amount of x-rays that pass through the bone is measured for each beam. This will vary depending on the thickness of the bone. Based on the difference between the 2 beams, the bone density can be measured.(MedicineNet.com)
Definition (NCI_CDISC) A technique for scanning bone and measuring bone mineral density (BMD).
Concepts Diagnostic Procedure (T060)
MSH D015502 , D003721
LNC LP133394-9
English Dual-Energy X-Ray Absorptiometry, dual-energy x-ray absorptiometry, Dual Energy X Ray Absorptiometry, X-Ray Absorptiometry, Dual-Energy, X Ray Absorptiometry, Dual Energy, DPX Absorptiometry, Absorptiometry, Dual X-Ray, Dual X-Ray Absorptiometry, Dual X Ray Absorptiometry, X-Ray Absorptiometry, Dual, Absorptiometry, Dual X Ray, Absorptiometries, DPX, Absorptiometry, DPX, Absorptiometry, Dual-Energy X-Ray, Absorptiometry, Dual Energy X Ray, dual-energy x-ray absorptiometry (DXA) scan, dual energy x-ray absorptiometry, dxa, Dual X-ray Absorptiometry, Dual Energy X-ray Absorptiometry, Dual-energy X-ray absorptiometry, DXA SCAN, dual energy x-ray absorptiometric scan, DXA, bone mineral density scan, DEXA, dual x-ray absorptiometry, BMD scan, Dual energy x-ray absorptiometry, DEXA scan
Dutch dubbele energie röntgenfoto absorptiometrie, DEXA-scan, Röntgenabsorptiemetrie, Dual-energy
French Absorptiométrie double énergie à rayons X, Examen par absorptiométrie à rayons X (DEXA), Absorptiométrie à rayons X en double énergie, Absorptiométrie à rayons X à double énergie, Absorptiométrie DEXA
German DEXA-Scan, Dual-Energie Roentgen-Absorptiometrie, DEXA, DXA, Absorptiometrie, Dual-Röntgen-, Dual-Röntgenabsorptiometrie, Röntgenabsorptiometrie, Dual-Energie-, Absorptiometrie, Dual-Energie-Röntgen-, Absorptiometrie, Doppel-Röntgen-, Doppel-Röntgenabsorptiometrie
Italian Mineralometria ossea a raggi X a doppia energia, Scansione DEXA, Assorbimetria a raggi X a doppia energia, Assorbimetria a doppio raggio X, Assorbimetria DPX
Portuguese Scan da avaliação de absorção com Raio X de energia dupla, Avaliação de absorção com Raio X de energia dupla
Spanish Absorciometría de rayos X de doble energía, Absorciometría por rayos X de doble energía
Japanese 二重エネルギーX線吸収法, DEXAスキャン, DEXAスキャン, ニジュウエネルギーXセンキュウシュウホウ
Czech DEXA snímek, Rentgenová denzitometrie, rentgenová absorpční fotometrie s duální energií
Hungarian DEXA vizsgálat, Kettős energiájú röntgen absorptiometria
Norwegian Røntgenbasert absorpsjonsmetri, dobbeltenergi, Dobbeltenergirøntgenabsorpsjonsmetri