Interpreting a DEXA scan

A T-score compares bone density with that of a healthy young adult reference group. A lower score indicates lower density; terms such as osteopenia or osteoporosis may be used when the result falls within recognised clinical ranges. A Z-score compares you with people of a similar age and sex, which can be more useful before menopause or in younger adults. Results can differ between the hip and spine, and degenerative changes can make spinal density appear higher than expected.

A fracture-risk assessment may be considered alongside the scan. Menopause timing, including premature ovarian insufficiency, and long-term steroid treatment can affect the discussion.

Take the full report to the clinician who requested it and ask which site and score are driving the plan. Do not start or stop calcium, vitamin D, steroid treatment or bone medicine based on the number alone. Review falls, balance, exercise, smoking, alcohol and dietary factors. Keep earlier scans available because change over time is interpreted using the same machine, reference method and expected measurement variation where possible.

Arrange prompt medical assessment after a new fracture from a minor fall, sudden severe back pain, or new difficulty standing or walking. Seek emergency help for severe pain after a fall, inability to bear weight, or weakness or numbness affecting movement. A low scan result without symptoms still deserves planned follow-up rather than emergency care.

Ask: Which score and body site matter most for me? Does my fracture history change the interpretation? When should the scan be repeated? What strength, balance, nutrition or medicine plan fits my health conditions?