REVIEW

The role of DXA bone density scans in the diagnosis and treatment of osteoporosis

Glen M Blake, Ignac Fogelman

King’s College London School of Medicine, London, UK

Correspondence to:
Correspondence to:
Glen Blake
PhD, Department of Nuclear Medicine, Guy’s Hospital, St Thomas Street, London SE1 9RT, UK; glen.blake{at}kcl.ac.uk

Dual energy x ray absorptiometry (DXA) scans to measure bone mineral density (BMD) at the spine and hip have an important role in the evaluation of individuals at risk of osteoporosis, and in helping clinicians advise patients about the appropriate use of antifracture treatment. Compared with alternative bone densitometry techniques, hip and spine DXA examinations have a number of advantages that include a consensus that BMD results can be interpreted using the World Health Organization T-score definition of osteoporosis, a proven ability to predict fracture risk, proven effectiveness at targeting antifracture therapies, and the ability to monitor response to treatment. This review discusses the evidence for these and other clinical aspects of DXA scanning, including its role in the new WHO algorithm for treating patients on the basis of their individual fracture risk.

Abbreviations: BMD, bone mineral density; BP, bisphosphonate; CV, coefficient of variation; DXA, dual-energy x ray absorptiometry; MrOS, Osteoporotic Fractures in Men Study; NHANES III, Third National Health and Nutrition Examination Study; NICE, National Institute for Health and Clinical Excellence; PDXA, peripheral dual-energy x ray absorptiometry; PTH, parathyroid hormone; QCT, quantitative computed tomography; QUS, quantitative ultrasound; ROC, receiver operator characteristic; RR, relative risk; SERM, selective oestrogen receptor modulator; SOF, Study of Osteoporotic Fractures; WHO, World Heath Organization

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