Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment
CPT4 code
Name of the Procedure:
Dual-energy X-ray Absorptiometry (DXA), Bone Density Study; Axial Skeleton (e.g., hips, pelvis, spine), including Vertebral Fracture Assessment
Summary
Dual-energy X-ray absorptiometry (DXA) is a non-invasive imaging procedure that measures bone density in the axial skeleton, which includes areas like the hips, pelvis, and spine. The scan also assesses vertebral fractures. It helps in diagnosing and monitoring bone health and conditions like osteoporosis.
Purpose
The procedure addresses bone-related medical conditions, mainly osteoporosis and bone fragility. The primary goal is to measure bone mineral density (BMD) and evaluate the risk of fractures, guiding treatment decisions for maintaining or improving bone health.
Indications
- Suspected osteoporosis or osteopenia
- History of fractures with minimal trauma
- Postmenopausal women and men over 50 with risk factors for low bone density
- Monitoring effectiveness of ongoing osteoporosis treatment
- Unexplained back pain or height loss indicating possible vertebral fractures
Preparation
- Wear loose, comfortable clothing, preferably without metal zippers, buttons, or belts.
- Inform the healthcare provider about any recent barium exams or contrast dye injections.
- No fasting is required, but avoid taking calcium supplements 24 hours before the test.
- A brief medical history and physical exam may be conducted beforehand.
Procedure Description
- The patient lies down on a padded table.
- The DXA machine, which has an X-ray generator below and an imaging device above, passes over the axial skeleton.
- The machine emits low-dose X-rays with two different energy levels to differentiate bone from other tissues.
- The spine or hip segments are scanned, taking images for bone density calculation.
- In the case of vertebral fracture assessment, additional scans focus on detecting minor to severe fractures.
- The patient remains still during the scan to ensure clear images.
No anesthesia or sedation is needed for this procedure.
Duration
The procedure typically takes 10 to 30 minutes.
Setting
The procedure is performed in a hospital radiology department, outpatient imaging center, or a specialist clinic.
Personnel
- Radiologist or certified DXA technologist
- Radiology technician or nurse
Risks and Complications
- Minimal radiation exposure, significantly lower than a standard X-ray.
- Rare possibility of slight discomfort from lying still.
Benefits
- Accurate measurement of bone mineral density.
- Early detection of osteoporosis and risk of fractures.
- Timely treatment interventions can be initiated.
- Results available shortly after the procedure, aiding immediate clinical decisions.
Recovery
- No recovery time is needed.
- Patients can resume normal activities immediately after the procedure.
- Follow-up appointments might be scheduled based on results.
Alternatives
- Quantitative Computed Tomography (QCT): More detailed but higher radiation exposure.
- Peripheral DXA: Measures bone density at peripheral sites like the wrist or heel, but less predictive of overall fracture risk.
- Ultrasound densitometry: Less common and less accurate for axial skeleton measurements.
Patient Experience
During the procedure, the patient will feel no pain. Some may feel slight discomfort from remaining still. After the scan, normal activities can be resumed without any special precautions.