At a glance
A bone densitometry scan, commonly called a DEXA scan (Dual-Energy X-ray Absorptiometry), is a quick imaging test that measures how dense and strong your bones are. Two low-dose X-ray beams pass through the body, and a detector records how much energy each beam absorbs; denser bone absorbs more, giving the machine enough data to calculate a score.
The result is reported as a T-score, a number that compares your bone density to that of a healthy young adult. A low T-score means your bones have lost mineral content and may be more likely to fracture. The scan cannot tell whether a fracture has already happened, but it is the standard way to detect osteoporosis (thinning of the bones) and osteopenia (early-stage bone loss) before a fracture occurs.
Medical Condition
Doctors request a DEXA scan when they want to assess fracture risk, confirm a diagnosis of osteoporosis, or monitor how well a treatment is working. It is most often used in women after menopause and in older men, but it is also ordered for younger people who have risk factors that accelerate bone loss.
- Osteoporosis or osteopenia, either suspected or already diagnosed
- Monitoring the effect of medications that treat bone loss, such as bisphosphonates or hormone therapy
- Long-term use of corticosteroids (steroid medicines), which are known to thin bone over time
- Early menopause or surgical removal of the ovaries, which reduces protective oestrogen
- A previous fragility fracture, meaning a bone that broke from a minor fall or bump
- Conditions that reduce calcium or vitamin D absorption, such as coeliac disease or inflammatory bowel disease
- Chronic kidney or liver disease that affects how the body processes bone minerals
- Hyperparathyroidism (overactive parathyroid glands that pull calcium out of bone)
- Hyperthyroidism (overactive thyroid gland linked to faster bone turnover)
- Low body weight or a history of an eating disorder
- Family history of osteoporosis or hip fracture in a parent
A DEXA scan is generally not needed when the result would not change the treatment plan, for example in someone who is already on anti-osteoporosis medication and being monitored at a set schedule. Pregnant women do not have the scan because even the small radiation dose is avoided during pregnancy. People who have had a contrast injection for another scan very recently may need to wait before having DEXA.
Risks & Complications
A DEXA scan is one of the lowest-risk medical tests available. The radiation dose is extremely small, far less than a standard chest X-ray, and there is no injection, no sedation, and no entry into the body.
- Minimal radiation exposure: the dose is so low that, in practice, it is not considered a meaningful health risk for the individual patient
- Slight discomfort from lying still on a hard table for several minutes, which can be difficult for people with back pain or mobility problems
- Inaccurate results if a previous contrast agent or nuclear medicine tracer is still present in the body
- Inaccurate results if the patient has spinal deformities (such as severe scoliosis, a sideways curve of the spine), significant arthritis, or metal implants in the scan area, as these affect how X-rays are absorbed
- No radiation risk is expected for the individual from a single or occasional scan; cumulative exposure from very frequent scanning is a theoretical consideration but rarely applies in practice
Preparation & Procedure
Very little preparation is needed for a DEXA scan, which is one reason it is convenient as a routine check. You can eat and drink normally on the day of the scan. You stop taking calcium supplements for at least 24 hours beforehand, because residual calcium in the gut can interfere with the reading.
Tell the imaging team about any recent scans that used a contrast agent or a radioactive tracer, such as a bone scan or a CT with contrast, as these can distort the result. Also tell them about any metal implants, joint replacements, or spinal hardware near the hip or spine, since these are the areas most commonly scanned. Wear loose, comfortable clothing without metal zips, buttons, or underwire, as you will be asked to remove any metal objects.
Pregnant patients or those who might be pregnant inform the team before the scan begins. Most facilities will postpone the scan until after delivery. No blood tests or other investigations are routinely needed beforehand, although your doctor may order a vitamin D or calcium blood level at the same visit.
- Stop calcium supplements at least 24 hours before the scan
- Eat and drink normally; no fasting required
- Wear clothes without metal fittings, or expect to change into a gown
- Remove jewellery, belt buckles, and keys before entering the scan room
- Tell the technician about previous contrast or nuclear medicine scans
- Tell the technician about any metal implants in the hip, spine, or wrist
- Inform the team if you are pregnant or think you might be
During the scan, you lie flat on a padded table. The scanner arm moves slowly over your body, usually focusing on the lumbar spine (the lower back), the hip, and sometimes the wrist. Each area takes only a few minutes. You are asked to stay still and breathe normally; there is no need to hold your breath. The whole appointment rarely takes more than 30 minutes, and the scan itself is usually completed in under 15 minutes.
Aftercare
There is no recovery period after a DEXA scan. You can dress, leave the facility, and return to all normal activities immediately. No wound care is needed because nothing enters the body. The follow-up after a DEXA scan is really about what the result shows and how the doctor responds to it.
- Resume calcium supplements and any regular medications straight away
- Ask the doctor when results will be available; in many centres a radiologist's report is ready within a day or two
- Attend the follow-up appointment where your doctor explains your T-score and what it means for your fracture risk
- If treatment is started, such as medication or vitamin D supplementation, a repeat DEXA scan is usually scheduled one to two years later to check the response
- Lifestyle measures your doctor may discuss include adequate calcium and vitamin D intake, weight-bearing exercise, fall prevention at home, and stopping smoking if relevant
- If your results are normal but you have ongoing risk factors, your doctor will advise how often the scan should be repeated, which varies widely depending on age and risk profile
Cost & What Determines It
The price of a DEXA scan varies considerably depending on where it is done and what surrounds it clinically. A standalone scan in a public hospital differs greatly from one that is part of a specialist consultation package in a private facility abroad.
- Number of body sites scanned: hip and spine together cost more than a single-site scan; adding the wrist or doing a full-body composition analysis adds further
- Hospital class and country: private hospitals in medical travel destinations typically charge differently from public hospitals, and prices differ significantly between countries
- Whether the scan is requested as part of a specialist visit or as a standalone test, since bundled consultations carry their own fees
- Radiologist reporting fee: some facilities charge separately for the written report, especially if a subspecialist in bone density interprets the result
- Need for follow-up investigations triggered by the result, such as blood tests for calcium, vitamin D, or parathyroid hormone
- The cost of any follow-up consultation to discuss results and, if needed, to start medication
Hospital packages sometimes bundle the scan, the radiologist report, and one follow-up consultation into a single price. What is often billed separately includes additional body sites scanned beyond the standard two, blood tests ordered alongside the scan, and any prescription written at the follow-up visit.
BPJS Kesehatan and most Indonesian private insurance plans do not cover treatment or investigations carried out abroad, so patients who travel for a DEXA scan typically pay out of pocket. Those with international private health insurance should check their policy in advance, as some do cover diagnostic tests overseas. Asking the hospital for a written cost estimate before travelling is the most reliable way to know exactly what you will pay and what is not included in the quoted price.
Frequently Asked Questions
Does a DEXA scan hurt?
A DEXA scan is painless. You lie still on a padded table while a scanning arm passes slowly over your body, and nothing touches or enters your skin.
How do I prepare for a DEXA scan? Do I need to fast?
You can eat and drink normally before a DEXA scan, so fasting is not required. You should avoid taking calcium supplements for at least 24 hours before the scan, as they can affect the reading. Wear comfortable, loose clothing and leave metal jewellery at home, since metal objects near the scan area can interfere with the images.
How long does a DEXA scan take?
The scan itself usually takes between 10 and 30 minutes, depending on which parts of the body are being measured. The hip and lower spine are the most commonly scanned areas. You can return to your normal activities immediately afterwards.
How much does a DEXA scan cost?
The cost of a DEXA scan depends on the class of hospital or clinic you choose and whether additional areas of the body are scanned beyond the standard sites. A written estimate from the hospital gives you the most reliable figure for your specific situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
