What does a bone density scan do and will my GP send me for one for osteoporosis?

A bone density scan—officially called a DEXA scan (Dual-Energy X-ray Absorptiometry)—measures the amount of bone mineral in your skeleton (usually focusing on your hip and lower spine) to check how strong your bones are and detect early bone loss or osteoporosis before a fracture happens.¹²³

Will your GP send you for one?

Your GP will refer you for a DEXA scan only if you meet specific clinical risk criteria rather than as a routine check for everyone. According to UK clinical guidelines (such as NICE), a GP is likely to arrange a scan if you have factors such as:¹²³

• You have broken a bone from a minor fall or low-impact injury (a fragility fracture).
• You have signs of a spinal fracture, such as unexplained back pain, a loss of height, or a change in posture.
• You have a high clinical risk score calculated via tools like FRAX (which looks at your age, gender, and family history).
• You have medical conditions that affect bone strength (such as rheumatoid arthritis, early menopause, or digestive conditions) or take long-term steroid tablets (glucocorticoids).
• You are starting a medical treatment that can impact your bone density.¹²³⁴⁵

If you are worried about your bone health or think you have risk factors, your best step is to discuss them directly with your GP so they can evaluate your fracture risk.¹²To help tailor this, could you share:

• Your age and gender?
• Whether you've had a recent broken bone or take medications like steroids?

This will help me give you a better idea of whether a GP typically recommends a scan in that situation.

What is a Bone Density Scan?

A bone density scan —officially called a DEXA scan (Dual-Energy X-ray Absorptiometry)—is a quick, painless imaging test that measures how strong and dense your bones are.¹

• How it works: It uses very low levels of X-rays to measure how much radiation passes through your bones. Dense bones absorb more radiation than fragile or thinning bones.¹
• What it shows: It helps diagnose osteoporosis (weak, brittle bones) or osteopenia (lower-than-normal bone density before it reaches osteoporosis) and assesses your risk of breaking a bone.¹
• What to expect: You simply lie flat on your back on a padded table while a scanner passes over your body (usually focusing on your hip and lower spine). It takes about 10 to 20 minutes and is completely non-invasive.

Will Your GP Send You for One?

Your GP will not automatically send everyone for a DEXA scan, as they follow clinical guidelines (such as those from the NHS Bone density scan (DEXA scan) or NICE) to decide who needs one. They typically consider a referral if you have specific risk factors or history pointing to potential bone loss:

• Age and menopause: Women are more prone to bone density loss after the menopause due to declining oestrogen levels.
• Previous fractures: If you have broken a bone from a minor bump or fall (a low-impact fragility fracture).
• Medical conditions: Conditions that affect bone health, such as rheumatoid arthritis, coeliac disease, or overactive thyroid/parathyroid glands.
• Medications: Long-term use of certain high-risk medications, particularly oral corticosteroids (like prednisolone) for conditions like asthma or arthritis.
• Lifestyle and family history: A family history of hip fractures, a low body mass index (BMI), heavy smoking, or high alcohol intake.
• FRAX score risk: If a fracture risk assessment tool (like FRAX or QFracture) used by your GP indicates that your 10-year probability of breaking a bone crosses a certain threshold.¹

If you'd like to share a bit more context, let me know:

• Why you're wondering (e.g., recent aches, a minor fall, or a family history)
• Your approximate age group or if you've started the menopause
• Any long-term medications you take

I can give you a better idea of what factors a GP typically weighs up.

A bone density scan is a simple, painless test that measures how strong your bones are and whether you have osteoporosis (thinning and weakening of the bones).

Yes, your GP can refer you for one if they think you may be at risk of osteoporosis. You don't have to wait until you've broken a bone to be investigated.

The scan is usually called a DEXA scan (or DXA scan).

1. What does a bone density scan do?

It uses a very low dose of X-rays to measure bone density, usually around two areas:

• Your lower spine.
• Your hip.

It can identify:

• Normal bone density – your bones are within the expected range.
• Osteopenia – your bones are weaker than normal, but you don't yet have osteoporosis.
• Osteoporosis – your bones are thinner and more fragile, increasing the risk of fractures.

The scan normally takes around 10–20 minutes. It's painless, and you don't need an injection or anaesthetic.

2. Will your GP refer you for one?

Yes, potentially. In the UK, GPs assess your risk of osteoporosis and may arrange a DEXA scan if appropriate.

They'll consider things such as:

• Your age.
• Whether you've gone through the menopause.
• Whether you have had an early menopause.
• Whether you've had a fracture following a minor fall or bump.
• Whether a parent has broken their hip.
• Whether you take steroid medication.
• Whether you have certain medical conditions that affect bone strength.
• Whether you've lost height or developed a stooped posture.

They may use a risk assessment tool called FRAX or QFracture to decide whether a scan is needed.

3. What happens after the scan?

You'll usually receive a result called a T-score.

If osteoporosis is diagnosed, your GP may discuss medication such as alendronic acid, which helps reduce bone loss and the risk of fractures.

A scan result is considered alongside your age, medical history and fracture risk. theros.org.ukwww.nhs.uk

4. When should you ask your GP?

I'd encourage you to make an appointment if you have concerns, particularly if you've experienced:

• Early menopause or menopause at a younger age.
• A fracture from a relatively minor fall.
• Noticeable loss of height.
• Persistent unexplained back pain.
• A family history of osteoporosis or hip fractures.

The NHS has further information here: Osteoporosis – NHS.

5. Can I ask you four questions?

I can help you understand whether you might have grounds to ask your GP for a DEXA scan.

1. How old are you?
2. Have you gone through the menopause? If so, approximately how old were you?
3. Have you ever broken a bone, even from a small fall or minor accident?
4. Are you concerned because of anything in particular? For example, family history, back pain, loss of height, medication or just wanting to check your bone health.

You don't necessarily need to have symptoms to have osteoporosis.

Depending on your answers, I can help you work out whether asking your GP for a bone density assessment would be sensible. ❤️