Maintain existing treatment schedule and return patient for dexa scan in approximately 2 years. View the aafp choosing wisely recommendation on dualenergy xray absorptiometry dexa screening for osteoporosis in women under age 65 or men under 70. It is commonly used to diagnose osteoporosis, to assess an. Interpreting a dxa scan in clinical practice intechopen. New and novel approaches to the interpretation of dxa body composition keep dxa at the forefront of applications ranging from infants to the morbidly obese, and athletes to the elderly. Specifically wondering if a letter to the patient regarding the dexa results is appropriate enough documentation to count as interpretation or if a separate note on the interpretation is needed. Understanding the results of your dxa test international. Dualenergy xray absorptiometry dexa is the technique of choice in the assessment of bone mineral density bmd, the average concentration of mineral in a defined section of bone. Bone density in the hip and spine can also predict the likelihood of future breaks in other bones. This manual focuses on dxa scan acquisition and analysis. This video is created in order to briefly explain how to understand that. Bone mineral density, dual energy xray absorptiometry, osteoporosis, osteopenia. Understanding your total body test reportoverview the traditional or typical dexa with which people are most familiar provides measurements of bone mineral density md in four spinal lumbars and left and right femurs.
Along with advice from your personal trainer, dietitian or exercise physiologist, a dexa body composition scan will provide you with the information you need to help you. Women discontinuing estrogen should be considered for bone density. Dual energy xray absorptiometry dxa procedures manual. And understanding those results is important if you are serious about strengthening your bones. A practical approach to interpretation of dualenergy xray. Dualenergy xray absorptiometry is the most widely used and most thoroughly studied bone density measurement technology. This method will be used to 1 monitor secular trends in overweight prevalence. Sv of radiation exposure from a spine and wholebody dxa scan is far less than the 80. Bone densitometry dexa, dxa bone densitometry, also called dualenergy xray absorptiometry, dexa or dxa, uses a very small dose of ionizing radiation to produce pictures of the inside of the body usually the lower or lumbar spine and hips to measure bone loss. Bone density scanning, also called dualenergy xray absorptiometry dxa or bone. A practical approach to interpretation of dualenergy x. Dxa measures the bone density at your spine and hip. Bone density scanning, also called dualenergy xray absorptiometry dxa or bone densitometry, is an enhanced form of xray technology that is used to measure bone loss.
Recommendations for osteoporosis screening with dexa scan. Dualenergy xray absorptiometry in the diagnosis of osteoporosis. A practical approach to interpretation of dualenergy xray absorptiometry dxa for assessment of bone density. Dualenergy xray absorptiometry dxa, previously dexa is a means of measuring bone mineral density bmd using spectral imaging. Dexa is a quick method that is accurate exact measurement of bmd, precise reproducible, and flexible different regions can be scanned and is performed with a low radiation dose 3, 4. Overview of dual energy xray absorptiometry dxa will be used to assess overall skeletal changes that often occur with age by measuring bone mineral content bmc and bone mineral density bmd. Dxa is todays established standard for measuring bone mineral density bmd an xray radiograph is a noninvasive medical test that helps physicians diagnose and treat medical. This is a pdf file of an unedited manuscript that has been accepted for publication. Any post menopausal woman should always request her tscore rather than just her zscore.
As bmd decreases from this peak density, fracture risk increases. It is used primarily in the diagnosis and management of osteoporosis and other disease states characterized by. Dec 08, 2017 your frax score is your risk of having an osteoporosisrelated fracture in the next 10 years. Article best practice guidelines for dxa scans and reports. One common test doctors use is called dual energy xray absorptiometry dxa or dexa. Understanding your total body test reportoverview the traditional or typical dexa with which people are most familiar provides measurements of bone mineral. Dexa scan should be several pages long, have many charts and xrays of the spine and hip. Performance, interpretation, and clinical application for technologists. This is one of the most accurate tests available today and is presently the most widely used technique that is used to measure bone density. Depending on specific factors, related to the clinical status of the patient or technical aspects of the test itself, interpretation of a dxa examination ranges from straightforward to complicated. One common test doctors use is called dual energy xray absorptiometry dxa or. Feb 05, 2016 many people, especially postmenopausal women, go to the doctor because of weak bones and get sent for a dexa bone scan. Premenopausal women and men younger than 50 will only have zscores.
Obtain copies of your full bone density reports from your dexa or dxa scans. A dexa scan is a quick and painless procedure that involves lying on your back on an xray table so an area of your body can be scanned. A bone density scan uses low dose xrays to see how dense or strong your bones are. Two xray beams, with different energy levels, are aimed at the patients bones. In the vast majority of our patients, we use our dxa interpretation to help answer three clinical questions. This gold standard test allows us to accurately determine your overall body fat mass and fat free mass including specific body segments being your arms, trunk, waist, hips and legs.
Pitfalls in measurement and interpretation of bone. All answers will be kept in strict confidence and treated as medical record information. Documentation needed for dexa compliance ask an expert. The most commonly used bmd test is called a central dualenergy xray absorptiometry, or central dxa test. If you are not sure how to answer a question, leave the space blank and we will assist you with the answer when you are seen at our facility. Choplin leon lenchik scott wuertzer published online. A practical approach to interpretation of dualenergy xray absorptiometry dxa for assessment of bone density robert h. Fundamentals, methodology, and clinical applications 411 indicaciones y las di. Dexa is not cost effective in younger, lowrisk patients, but is cost effective in older patients.
Clinical studies have demonstrated that abnormalities in body composition are a key predictor of health risks, including obesityrelated diseases, sarcopenia, and. The dxa scan is typically used to diagnose and follow osteoporosis, as contrasted to the nuclear bone scan, which is sensitive to certain metabolic diseases of bones in which bones are attempting to heal from infections. Body fat testing is a great way to have an accurate metric for your body composition. The young normal or tscore indicates how your bmd compares to that of a healthy 30 yearold. It is used primarily in the diagnosis and management of osteoporosis and. Interpretation and use of frax in clinical practice. Interpretation of dxa scans deborah sellmeyer, md professor of medicine division of endocrinology, gerontology, and metabolism stanford university, school of medicine dxa technology xray source two energies with different attenuation profiles collimator pinhole for pencil beam, slit for fan beam patient.
The test can identify osteoporosis, determine your risk for fractures broken bones, and measure your response to osteoporosis treatment. The core elements of this program focus on performing quality dxa scans, dissecting the data and applying this knowledge to a technologists role in patient care. Your dexa scan test results how to interpret the scores. Dxa scan results at the hip in a 67yearold woman with a history of proximal humerus fracture. Dualenergy xray absorptiometry dxa scans are costeffective examinations to monitor changes in bone mineral density bmd, to assess fracture risk, and to diagnose osteopenia and osteoporosis. Survey nhanes by dual energy xray absorptiometry dxa scans of the femur and anteriorposterior ap spine. Advances in dxa technology, combined with rising rates of obesity and other musculoskeletal disorders, are driving widespread adoption of dxa scans to evaluate body composition. Dualenergy xray absorptiometry interpretation and reporting in children and.
Dualenergy xray absorptiometry dexa scans provide a stateoftheart way to assess your body composition. Composition scans if youre serious about your fitness or weightloss program, you need to have a dexa body composition scan to assess and show the distribution of your body fat. Bone densitometry in children and adolescents american. Body composition measurements from dxa have been available since dxa technology was developed 30 years ago, but are historically underutilized. Interpreting bmd measurements in children is complicated by the growing skeleton.
This may be asking you to have a bone scan, or talking to you about measures that can help prevent. Introduction osteoporosis is a metabolic bone disorder characterized by low bone mass and microarchitectural deterioration, with a subsequent increase in bone fragility and susceptibility to fracture. Scanning of the axial skeleton by dual energy xray absorptiometry dxa is the gold standard in australia for the measurement of bone mineral density bmd. Your frax score is your risk of having an osteoporosis related fracture in the next 10 years. Ucsf department of radiology and biomedical imaging.
Dexafit is the gold standard for body fat testing, body composition analysis, dexa scans, vo2max testing, rmr analysis, heart rate fitness, hormone testing, metabolic tests and more. With most types of bone density tests, a person remains fully dressed, but you do need to make sure no buttons or zippers are in the way of the area to be scanned. However, when dxa studies are performed incorrectly, it can lead to major mistakes in diagnosis and therapy. Dxa scans are also interpreted by other physicians such as rheumatologists and endocrinologists. Find out what it means, how its calculated, and more. Dexa scan help for understanding your results better bones. The frax results are shown on the dxa printout just below the bmd results. Dualenergy xray absorptiometry in the diagnosis of. Official positions international society for clinical.
Even with an abnormal dexa scan, the risk of fracture is still very low, and treatment isnt. Oct 26, 2015 ground rules for understanding more about dexa scan results. Bone density testing in general practice poor bone health is common in australia an estimated 4. Dxa allows accurate diagnosis of osteoporosis, estimation of fracture risk and monitoring of patients undergoing treatment. A zscore compares your bone density to the average bone density of people your own age and gender. This information can help your doctor decide whether further action needs to be taken. A radiologist, a physician specifically trained to supervise and interpret. Bone density scan dexa scan how it is performed nhs. Bone mineral measurements lippincott cmeconnection wolters. For example, if you are a 60yearold female, a zscore compares your bone density to the average bone density of 60yearold females. Dualenergy xray absorptiometry dxa scans to measure bone mineral density at the spine and hip have an important role in the evaluation of individuals at risk of osteoporosis, and in helping.
Dxa is todays established standard for measuring bone mineral density bmd. However, dxa is highly dependent on the quality of scan acquisition, analysis, and interpretation. Peak bone density is reached by age 30 and should ideally. Sv accumulated during a roundtrip transatlantic flight. Recently, there have been rapid developments in body composition assessment including the analysis and publication. In clinical practice, recognition of diverse artifacts and disease processes that may influence bmd results can be of major importance in the optimal interpretation of dxa scans. Oct 19, 2012 a dexa scan is a technique that is used to measure the density of bone mineral. Dexa result is based on the worst score of the individual scores of the spine, total hip, femoral neck, and when applicable, the onethird radius forearm. Dualenergy xray absorptiometry dxa is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density bmd. Dexa is a quick method that is accurate exact measurement of bmd, precise reproducible, and flexible different regions can be scanned and is performed with. Dexa for osteoporosis recommendation dont use dualenergy xray absorptiometry dexa screening for osteoporosis in women under age 65 or men under 70 with no risk factors. Testing your bone density how strong your bones are is the only way to know for sure if you have osteoporosis. Doctors, with the help of a dexa scan, are able to confirm or verify the condition osteoporosis. Suggested explanation of dxa scans english version it will take a few minutes to position you correctly for each scan and another few minutes to take the scans.
Dxa, which stands for dualxray absorptiometry, is a low radiation xray capable of detecting very small percentages of bone loss. Youll want to look at all the results, not just the summary page. Explanation of body composition assessment results. Without major improvements in diagnosis and management, the rate of. The tscore is a comparison of a persons bone density with that. How to interpret your body fat test invictus fitness. There are many ways of getting your body fat tested, but most experts will agree that the dexa dualenergy xray absorptiometry scan is the most accurate testing technology available. Dexafit is the gold standard for body fat testing, body composition analysis, dexa scans, vo2max testing, rmr analysis, heart rate fitness, hormone testing. Pitfalls in measurement and interpretation of bone mineral density. Dont use dualenergy xray absorptiometry dexa screening for osteoporosis in women under age 65 or men under 70 with no risk factors. Instances where reporting and interpretation of dxa. How to interpret your body fat test written by calvin sun. Other means of assessing bone strength are also available but a dexa scan is currently the most accurate method and it uses the lowest amount of radiation a standard chest xray exposes you to 10 times more radiation than a typical dexa scan.
Peak bone density is reached by age 30 and should ideally be maintained at this level throughout your life. Dxa scanning focuses on two main areas the hip and the spine. Pdf interpreting a dxa scan in clinical practice researchgate. Can anyone tell me what documentation requirements are needed to bill for a bone density interpretation and report. Frax was incorporated into dxa scan ners to provide frax probabilities at the time of dxa. Osteoporosis screening, diagnosis, and treatment guideline. Premenopausal i usually have regular menstrual periods perimenopausal irregular periods, but i have had at least 1 period in the past 12 months. Jul 09, 2012 before interpreting pediatric dxa scan, a physician should be clear that diagnosis of osteoporosis can not be reached on the basis of bmd alone because till now there is paucity of data which corelates bmd scores with fracture risk, also bmd estimation is affected by bone area which is variable in children. Along with advice from your personal trainer, dietitian or exercise physiologist, a dexa body composition scan will provide you with the information you need to help you achieve your goals. Changes have been made to the 2010 car technical standards for bone mineral densitometry reporting to incorporate principles from the 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in canada from osteoporosis canada. It is a safe and noninvasive method of testing which exposes you to less radiation than a mammogram. Please select the ethnicity that best describes you patient name.
A dexa scan is a technique that is used to measure the density of bone mineral. Understand specific consideration for interpreting dxa in children, premenopausal. Bone density scans are often used to diagnose or assess your risk of osteoporosis, a health condition that weakens bones and makes them more likely to break. The defining characteristic of osteoporosis is reduced bone mineral density as identified by dual energy xray absorptiometry dxa. The clinical utility of dxa is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Continued interpreting your dexa bone scan results.
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