DEXA bone density scan (Dual-energy X-ray absorptiometry (DXA))
A quick, low-dose X-ray scan that measures how dense your bones are, to help work out your risk of osteoporosis and broken bones.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A DEXA scan measures bone density to help assess osteoporosis and fracture risk.
- Density is only part of bone strength, so the result is interpreted with a fracture risk score, not on its own.
- It is quick and usually not painful, with a very low radiation dose, but it is not suitable in pregnancy.
- A result in the osteoporosis range does not automatically mean you need medicine; treatment depends on your overall risk.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your radiologist will give you advice for your situation.
Gives an objective measure of bone density to support a diagnosis of osteoporosis
Pregnancy, as X-rays are avoided unless there is an exceptional reason.
You lie still on an open table for around 10 to 20 minutes. The scan is usually not painful and you remain dressed.
A clear report with the T-score combined with a formal fracture risk score.
You lie still on an open table for around 10 to 20 minutes. The scan is usually not painful and you remain dressed.
You can go home and carry on as normal. There are no after-effects and no need for anyone to drive you.
A specialist reads the images and a report is sent to the requesting clinician, with your T-score and an...
Your clinician combines the result with a fracture risk score and your history to advise on lifestyle...
What is a DEXA bone density scan?
A DEXA (or DXA) scan is a special, low-dose X-ray that measures the density, or thickness, of your bones, usually at the hip and lower spine. Denser bones are generally stronger. The scan is mainly used to help diagnose osteoporosis, a condition where bones become weaker and more likely to break, and to estimate your risk of a fracture.
The result is given as a T-score, which compares your bone density with that of a healthy young adult. A T-score of -1 or above is normal, between -1 and -2.5 suggests lower-than-average density (osteopenia), and -2.5 or below is in the osteoporosis range. Younger people and children may instead be given a Z-score, which compares them with people of the same age.
It is important to know what the scan cannot do. Bone density is only one part of bone strength; it does not measure bone quality or directly predict whether you will break a bone. That is why results are read alongside a fracture risk tool (such as FRAX or QFracture) and your other risk factors, rather than in isolation.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
DEXA scan compared with a standard X-ray
| Feature | DEXA scan | Standard X-ray |
|---|---|---|
| Main purpose | Measures bone density | Looks at bone shape and fractures |
| Detects early bone thinning | Yes | Not reliably |
| Radiation dose | Very low | Higher than DEXA |
| Gives a T-score | Yes | No |
A standard X-ray can show a broken bone but cannot measure density well; DEXA is the usual test for assessing osteoporosis.
Preparing for your scan
- Tell the team if you are, or might be, pregnant, as the scan is not done in pregnancy.
- Let them know if you have recently had a scan using contrast dye or a radioactive tracer (such as a barium test or nuclear medicine scan), as you may need to wait.
- Wear loose, comfortable clothing without metal zips, buttons or clasps; you may be asked to remove jewellery.
- Mention any previous fractures, hip or spine surgery, or metal implants, as these affect which sites are measured.
- Bring details of previous bone scans so results can be compared on the same machine where possible.
- Take your usual medicines unless told otherwise; calcium supplements may need to be paused briefly for some machines, so check.
What happens
A DEXA scan is done as an outpatient and you stay dressed in suitable clothing. You lie on your back on a padded table while a scanning arm passes slowly above you. You do not go inside a tunnel, so it is well suited to people who find enclosed scanners difficult.
The radiographer may position your legs or feet with a soft support to get a clear view of the hip and spine. You will be asked to stay still and may need to hold your breath briefly. The scan itself is usually not painful and usually takes around 10 to 20 minutes.
The images are read by a specialist, who calculates your bone density and T-score and writes a report. This is then combined with your fracture risk assessment to advise on what, if anything, should be done.
Is this scan right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Pregnancy, as X-rays are avoided unless there is an exceptional reason.
- Using DEXA to investigate bone pain, cancer or osteoarthritis, which it does not assess.
- Scanning before a fracture risk assessment, as NICE advises assessing risk first.
- Relying on a hip or spine result where heavy arthritis, old fractures or metalwork make those sites unreliable.
Delay or rearrange if…
- You have recently had a scan with contrast dye or a radioactive tracer.
- You might be pregnant.
- You have a recent spinal fracture that would distort the spine measurement, until advised.
- A previous scan on a different machine needs to be located first for fair comparison.
Alternatives to discuss
- Fracture risk assessment with FRAX or QFracture alone, without a scan, in some cases.
- No scan if the result would not change your management.
- Blood tests and clinical review to look for treatable causes of bone loss.
- Specialist referral if an unusual bone condition is suspected.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Gives an objective measure of bone density to support a diagnosis of osteoporosis
- Helps estimate fracture risk when combined with a risk tool and your history
- Can detect bone thinning before any fracture happens
- Provides a baseline to monitor changes over time or response to treatment
- Uses a very low radiation dose and is quick and usually not painful
Risks & complications
- Very low radiation exposure (less than a few days of natural background radiation)
- A result that needs interpreting carefully, as density alone does not equal bone strength
- Inconvenience of attending and, sometimes, waiting for the report
- Falsely high or low readings if there is spinal arthritis, old fractures, metalwork or recent contrast/tracer in the body
- An osteopenia or osteoporosis result that causes worry but may not require medicine
- Difficulty measuring the hip or spine, needing a forearm scan instead
- Being given treatment, or reassurance, based on the scan alone without the wider risk picture
- Missing a fracture risk that lies in bone quality rather than density
The main limitation is that DEXA measures density, not the full strength of bone, and becomes less reliable over the age of about 75 or where the spine is heavily arthritic. Ask whether your result has been combined with a fracture risk score, and what the plan is if the numbers and your history point in different directions.
Published figures to discuss
A DEXA scan is a very low-risk test, so meaningful complication rates are not the issue. What varies is how well the result predicts fractures and how reliable the measurement is in certain people. The radiation point below is included because patients often ask; it is not a complication.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Radiation dose | Very low, broadly equivalent to a few days of natural background radiation and far below a chest X-ray | Avoided in pregnancy; otherwise considered negligible for adults. | Guide sourcesClinical context |
| False reassurance from a normal T-score | Recognised | Many fragility fractures occur in people whose bone density is not in the osteoporosis range; clinical fracture risk still matters. | NICE NG259 — Osteoporosis: fragility fracture risk assessmentnice.org.ukSource-linked context |
| Misleading comparison between scans | Recognised | Different machines, positioning, osteoarthritis and vertebral deformity can alter readings. Follow-up is best done on the same scanner when possible. | Guide sourcesClinical context |
| Missed vertebral fracture | Recognised | Height loss, back pain or steroid exposure may need vertebral fracture assessment or spine imaging, not just hip/spine BMD. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from a DEXA scan. You can return to normal activities straight away; what matters afterwards is how the result is interpreted alongside your other risk factors.
- No physical symptoms after the scan
- A short wait for the written report
- Needing a follow-up discussion to make sense of the numbers
- Sometimes being advised to repeat the scan in a few years rather than acting now
Aftercare
- Carry on with normal activities, eating and drinking straight away.
- Make sure you have a follow-up arranged to discuss the result, not just the number.
- Ask for your T-score and what it means in plain terms.
- Discuss calcium, vitamin D and lifestyle (weight-bearing exercise, smoking, alcohol) as part of the picture.
- If treatment is advised, ask why, what the benefits and side effects are, and for how long.
- Keep the report so future scans can be compared with it.
- Pregnancy possibility checked beforehand
- Details of any recent contrast or tracer scans shared
- Record of previous fractures and bone scans brought
- Loose, metal-free clothing for the appointment
- Follow-up appointment to discuss results arranged
- Questions written down about treatment and monitoring
⚠ Get urgent help if…
- Sudden, severe back pain after a minor strain or no obvious cause, which can signal a spinal fracture
- A new fracture from a low-impact fall or knock
- Loss of height or a developing stoop over time
- Severe, persistent bone or joint pain
- Side effects from any osteoporosis medicine that concern you, such as jaw pain or unusual thigh pain on treatment
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your radiologist gives you.
Results & realistic expectations
A normal result is reassuring but does not guarantee you will never break a bone, because density is only part of bone strength. A result in the osteopenia or osteoporosis range raises your estimated fracture risk, but whether you need treatment depends on your overall risk, not the T-score alone.
The scan is a snapshot of density at the time it was taken. It cannot, by itself, tell you whether a fracture will happen, nor measure the internal quality of bone. This is why your clinician interprets it alongside a fracture risk tool such as FRAX or QFracture and factors like age, previous fractures, family history, steroid use, smoking and alcohol.
Bone density changes slowly, so a repeat scan is usually only useful after a couple of years or more, often to check response to treatment or significant change in risk. NICE advises against routinely repeating scans too soon, as small changes can be within the margin of error. Your clinician will advise when, or whether, a repeat is worthwhile.
Related tests, treatments or support
A DEXA scan is often combined with blood tests (for example calcium, vitamin D, kidney and thyroid function) to look for treatable causes of bone loss, and sometimes with a vertebral fracture assessment at the same visit. The result is always read alongside a formal fracture risk assessment.
Follow-up & long-term care
Your result is sent to the clinician who requested it, who will discuss it with you and decide on next steps. If treatment is started you will usually be reviewed to check you are tolerating it, with a repeat scan only after a suitable interval.
- Adequate calcium and vitamin D, as advised by your clinician
- Regular weight-bearing and muscle-strengthening exercise where safe
- Stopping smoking and keeping alcohol within recommended limits
- Repeat DEXA only at the interval your clinician recommends, often after two years or more
- Ongoing review if you are on osteoporosis medicine
Repeat, follow-on and what comes next
- Hip or spine measurements sometimes cannot be used (arthritis, old fractures, metalwork), so a forearm scan may be substituted.
- Repeat scanning too soon often shows changes within the margin of error and adds little.
- A borderline result may be reassessed after lifestyle changes or with a fracture risk tool rather than acted on immediately.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear report with the T-score combined with a formal fracture risk score.
- A discussion of lifestyle, calcium and vitamin D as well as any medicine.
- Tests for treatable causes of bone loss where appropriate.
- A sensible plan for if and when to repeat the scan, and review of any treatment started.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Which sites are scanned (hip and spine, forearm, or vertebral fracture assessment)
- Specialist reporting and whether a fracture risk assessment is included
- Whether a follow-up consultation to explain the result is part of the price
- Any blood tests arranged to look for treatable causes of bone loss
- Whether the scan is a baseline or a comparison with previous images
- Clinic facility fees
- The scan fee and which body sites are included
- Whether specialist reporting is included
- Whether a fracture risk assessment (FRAX or QFracture) is provided
- Whether a consultation to explain the result is included or extra
- The cost of any recommended blood tests
- What happens, and what it costs, if a repeat or further scan is advised
On the NHS? DEXA scans are available on the NHS when a fracture risk assessment shows a scan would change your care; private scans may be used for speed or self-referral but should still be interpreted with a fracture risk tool.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Treating the T-score as a diagnosis on its own, without a fracture risk assessment.
- Not explaining that density is only part of bone strength.
- Recommending medicine purely on the scan number without discussing overall risk and alternatives.
- No plan for how, or whether, the scan should be repeated.
Marketing red flags
- Private 'bone health checks' offered without any fracture risk assessment.
- Suggesting everyone should be scanned regardless of risk.
- Implying a normal scan means you can never break a bone.
- Pushing supplements or treatment off the back of a single scan.
Choosing a specialist safely
- Check the radiologist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the radiologist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good radiologist will welcome every one of these.
- Has my T-score been combined with a fracture risk score such as FRAX or QFracture?
- What does my result mean for my actual risk of breaking a bone?
- Are there treatable causes of bone loss that I should be tested for?
- Do I need treatment now, or lifestyle measures and monitoring?
- When, if at all, should this scan be repeated?
- Could spinal arthritis or old fractures be affecting my result?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the radiologist who carries out my scan, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this scan not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a DEXA scan safe? How much radiation is involved?
Does the scan hurt or feel enclosed?
What does my T-score mean?
If I'm in the osteoporosis range, do I have to take medicine?
Can I get a DEXA scan on the NHS?
How often should I have one?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Bone density scan (DEXA scan) Royal Osteoporosis Society — Bone density scan (DXA) NICE NG259 — Osteoporosis: fragility fracture risk assessment The role of DXA scans in diagnosis and treatment of osteoporosis — PMC NHS — DEXA scan: why it is used NICE NG259 — Identifying vertebral fragility fractures NICE NG259 — Deciding whether pharmacological treatment is appropriate
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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