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DEXA scans are used to check the density of bones. This test uses X-rays to show how strong bones are.

Note: the information below is a general guide only. The arrangements, and the way tests are performed, may vary between different hospitals. Always follow the instructions given by your doctor or local hospital.

DEXA stands for 'dual-energy X-ray absorptiometry'. DEXA (also sometimes known as DXA) is a test that measures the density of bones. Density means how much of something there is in a certain amount of space. The denser the tissue, the less X-rays pass through. Air and water are less dense than solid things such as bone. This is because the particles which make air and water are not held closely together. In general, the more dense the bone, the stronger it is, and the less likely it is to break (fracture).

There are two different types of DEXA scanning devices:

  • Central DEXA devices are large machines that can measure bone density in the centre of your skeleton, such as your hip and spine.
  • Peripheral DEXA devices are smaller, portable machines that are used to measure bone density on the periphery of your skeleton, such as your wrist, heel or finger. These are mainly to get an idea about whether further tests are needed, as they are not as accurate as the larger DEXA machines.

A DEXA scan uses low-energy X-rays. A machine sends X-rays from two different sources through the bone being tested. Bone blocks a certain amount of the X-rays. The more dense the bone is, the less X-rays get through to the detector. By using two different X-ray sources rather than one it greatly improves the accuracy in measuring the bone density.

The amount of X-rays that comes through the bone from each of the two X-ray sources is measured by a detector. This information is sent to a computer which calculates a score of the average density of the bone. A low score indicates that the bone is less dense than it should be, some material of the bone has been lost, and it is more prone to fracture.

You lie on your back on a couch and are asked to keep still while an X-ray detector (the 'scanner') comes over the area to be tested. An X-ray machine fires X-rays towards the detector. The bones commonly scanned are the bones of the back (the vertebrae), hip and wrist. The scan usually takes between 10 and 20 minutes, depending on which part of your body is being examined and whether a central or peripheral scanner is being used. Peripheral scanners are available in some GP surgeries and can be used to check the bone mass density of the heel, wrist or finger.

DEXA scanner

By Nick Smith photography (ALSPAC web site), via Wikimedia Commons.

DEXA scans use a very low level of X-ray radiation. This means it is safe for the technician doing the scan to stay in the room with you. (In standard X-ray tests, the technician has to stay behind a protective screen.)

You do not need to do any special preparation prior to a DEXA scan.

A DEXA scan may be advised if you are at increased risk of 'thinning' of the bones (osteoporosis). Osteoporosis usually causes no symptoms at first. However, if you have osteoporosis, you have an increased risk of breaking a bone. See separate leaflet called Osteoporosis for more details. If a DEXA scan shows that you have osteoporosis then you may be given advice and treatment to help strengthen your bones. Therefore, a DEXA scan may be advised if you have:

If your doctor thinks you have risk factors for osteoporosis, they may use a risk calculator such as one called FRAX®. This gives an idea of how likely you are to fracture your bones after a minor knock. If your risk is at a medium level, your doctor would then arrange a DEXA scan. This enables them to gain a clearer picture of your risk and then to decide whether you need any treatment.

Further help & information

National Osteoporosis Society

Camerton, Bath, BA2 OPJ

Tel: (Freephone) 0808 800 0035, (General) 01761 471771

Further reading & references

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Dr Rachel Hoad-Robson
Current Version:
Dr Mary Harding
Peer Reviewer:
Dr John Cox
Document ID:
4736 (v41)
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