DXA Bone Density Program | For Clinicians

The dual energy X-Ray absorptiometry (DXA) request form should be completed by the primary care provider or referring doctor who is requesting a bone density test. This request form is used by the doctor specializing in bone health and the technologists to help identify which skeletal sites will be scanned for a patient.

We will have to cancel a patient's appointment within 24 hours if the DXA request form is not received prior to that date.

International Society for Clinical Densitometry (ISCD) recommended scan sites per age:

• 4 to 15 years old: total body and spine
• 16 years + for an initial scan: hip and spine
• 16 years + for a follow-up scan: hip and spine
• 16 years + for a follow-up scan: total body, spine, and hip (one time during transition to hip and spine)

If you would like body composition performed, please add this additional scan to your order.

• If your patient has spinal hardware, please order a hip and forearm.
• If your patient has hip or femur hardware in both hips, please order a spine and forearm.
• If your patient has orthopedic hardware in a different location than those specified above, please order a hip and spine.
• If your patient has difficulty holding still, please refrain from ordering a TBLH.

Providers within Boston Children’s: Please place an order in the electronic medical record.

Outside providers: Please use our DXA requisition form and fax your completed form to the number listed on the requisition.

You’ll be seen by ISCD-certified staff

Our program works closely with the International Society of Clinical Densitometry (ISCD) to capture the highest quality DXA scans. All of our technologists and clinicians are ISCD certified.

How to measure BMC and BMD

In children, measurements of bone mineral content (BMC) and bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) may be influenced by height status, leading to potential underestimation of bone density in shorter children. This discrepancy arises because DXA, being a two-dimensional imaging technique, does not account for bone depth.

Consequently, smaller bones with equivalent volumetric BMD (measured in grams per cubic centimeter) tend to exhibit lower areal BMD readings.

To address this issue, especially when managing patients of below-average stature where adjusting bone density for height could impact clinical decisions, we recommend using this calculator for height adjustment. By incorporating this adjustment, healthcare providers can obtain more accurate assessments of bone density in pediatric patients, thereby ensuring appropriate clinical management tailored to individual needs.

Research that details the use of DXA in children

This research paper provides a summary of all ISCD positions on pediatric DXA.