Dual-Energy X-ray Absorptiometry (DXA) Bone Density Scanning Protocol

Pre-Scan Procedures

Patient Preparation

• Verify patient identification and screening documentation
• Confirm absence of recent radiological procedures
• Remove metal objects, jewelry, and clothing with metal components
• Document patient height and weight
• Screen for pregnancy in women of childbearing age

Equipment Preparation

• Perform daily QC phantom scan
• Calibrate densitometer if required
• Clean and sanitize equipment surfaces
• Ensure proper room temperature (20-25°C)

Scanning Protocol

Standard Scan Regions

1. Lumbar Spine (L1-L4)

   • Position patient supine
   • Center patient using laser guides
   • Elevate legs using support block (knee-hip angle 60-90°)

2. Proximal Femur

   • Rotate hip internally 15-25°
   • Secure foot in positioning device
   • Ensure femoral shaft is parallel to image border

3. Forearm (when indicated)

   • Position arm parallel to long axis of scanner
   • Center ulnar styloid process

Image Acquisition

• Select appropriate scan mode based on patient size
• Verify correct patient positioning before initiating scan
• Monitor patient movement during acquisition
• Repeat scans if significant movement occurs

Post-Scan Procedures

Analysis

• Review scan quality
• Verify ROI placement
• Document artifacts or anatomical variations
• Compare with previous studies if available

Reporting

• Generate standardized report including:
  • BMD measurements
  • T-scores and Z-scores
  • FRAX® score when applicable
  • Comparison with previous scans
  • Technical comments

Quality Control

Daily QC

• Phantom scanning
• Equipment inspection
• Background radiation check

Monthly QC

• Cross-calibration if multiple units
• Precision assessment
• Documentation review

Safety Considerations

• Maintain radiation safety protocols
• Document radiation exposure
• Follow infection control procedures
• Maintain emergency protocols