08/27/2026
THE DEXA SCAN - The Disease You Can't Feel Until It's Too Late
Osteoporosis is often called the "silent disease" — and for good reason. There's no pain, no symptoms, no warning sign that your bones are weakening. Most people don't find out they have it until they've already broken a bone. (U.S Pharmacist)
Here's how common — and how underdiagnosed — it really is:
Approximately 10 million Americans have osteoporosis, and another 44 million have low bone mass that puts them at increased risk.
Studies suggest roughly one in two women — and up to one in three men — over age 50 will break a bone due to osteoporosis in their lifetime.
A woman's risk of a hip fracture is equal to her combined risk of breast, uterine, and ovarian cancer. (U.S Pharmacist) In the five to seven years after menopause, women can lose up to 20% or more of their bone density — often without any indication anything has changed.
And yet, screening rates remain surprisingly low. A 2025 federal analysis found only 42.8% of women 50 and older without a prior diagnosis had ever had a DEXA scan — despite the U.S. Preventive Services Task Force recommending DEXA screening for all women 65 and older, and for younger women with elevated risk factors. (AHRQ American Academy of Family Physicians)
A quick but important distinction:
Not all DEXA scans are measuring bone the same way — and knowing the difference helps you get the right test the first time.
A whole-body composition DEXA scan (the kind most people get for fat, muscle, and visceral fat tracking) does include a bone mineral content reading as part of the results. It's a useful early indicator, and if your numbers come back lower than expected, it's a signal worth paying attention to.
But it's not the diagnostic standard. To officially diagnose osteoporosis or osteopenia, you need a dedicated hip and spine DEXA scan — the clinical bone density test that targets the femoral neck and lumbar spine specifically. This is the gold-standard method for measuring bone mineral density, and it's the only scan that generates your true T-score and Z-score: (nih)
T-score compares your bone density to that of a healthy 30-year-old adult — a T-score of -2.5 or lower at the femoral neck, lumbar spine, or distal radius is what defines osteoporosis (nih)
Z-score compares your bone density to others your same age, s*x, and body size — useful for spotting bone loss that's unusual for your age group.
P.S. — Recommended for anyone 50+, postmenopausal, or with a family history of osteoporosis. Already had a body composition scan with a lower-than-expected bone reading? That's exactly the reason to book the hip and spine scan next.
