At what age should you get a bone density scan, and why?

Key takeaways

• Bone densitometry measures bone mineral density in the spine and hips to assess osteoporosis and fracture risk;
• Postmenopausal women are the group most affected because bone loss accelerates after menopause;
• A first test is recommended starting at age 65 for women, but it may be prescribed earlier if risk factors are present;
• For men, screening may be considered starting at age 70 in the presence of risk factors;
• Certain situations justify testing regardless of age: fragility fracture, prolonged corticosteroid use, diseases associated with bone loss;
• The test is covered by RAMQ once a year with a medical prescription;
• Bone densitometry is painless and quick: about 10 minutes, with no injection and no burdensome preparation.

What exactly does bone densitometry measure?

Bone densitometry, also called DXA or dual-energy X-ray absorptiometry, is the reference test for measuring bone mineral density. It assesses bone strength at specific sites, mainly the spine and hips, two areas that are especially vulnerable to osteoporosis-related fractures.

The result is expressed as a T-score, which compares your bone density to that of a healthy young adult. This score allows your doctor to estimate your 10-year fracture risk and, if necessary, guide preventive treatment.

📖 Definition — Osteoporosis: a disease of bone demineralization characterized by a loss of calcium and phosphorus. It weakens the skeleton and significantly increases the risk of fracture, sometimes following minor trauma.

At what age should women have a bone density scan?

Recommendations vary by country, but a first test is generally recommended starting at age 65 for women without particular risk factors. This is the age when menopause-related bone loss has had time to become established and significantly weaken the skeleton.

Your doctor may prescribe the test earlier if your personal situation warrants it. The important thing is not to wait for a fracture before taking action.

💡 Tip — If you are over 65 and have never had a bone density scan, talk to your doctor about it at your next appointment. It is a simple test, covered by RAMQ, that plays an important role in preventing non-traumatic fractures.

Are men also affected by the need for bone densitometry?

Osteoporosis also affects men, even though it generally develops later and more gradually than in women. With age, testosterone production naturally declines. This hormonal drop slows bone renewal and leads to a gradual loss of bone mineral density. The process is less abrupt than it is in women after menopause, but its effects build up over time.

Current recommendations from the Collège des médecins du Québec indicate that screening in men aged 70 to 90 is left to the clinician’s judgment. Your doctor assesses on a case-by-case basis whether a bone density scan is appropriate based on your health status and medical history.

📋 Good to know — To assess fracture risk, doctors use the FRAX tool (Fracture Risk Assessment Tool). Using several clinical data points, it calculates 10-year fracture risk and helps determine whether a patient should be referred for bone densitometry, if necessary. 

What risk factors justify earlier testing?

Certain situations increase the risk of osteoporosis regardless of age. In such cases, your doctor may prescribe a bone density scan well before the usual thresholds of age 65 or 70. 

The main factors that accelerate bone demineralization are as follows:

• Prolonged use of corticosteroids (cortisone), which significantly accelerate bone loss;
• A low body mass index (low BMI), which is generally associated with lower bone density;
• Smoking, a recognized factor in bone fragility;
• Excessive alcohol consumption, which disrupts bone metabolism;
• A family history of osteoporosis or hip fracture in a first-degree relative;
• Certain chronic diseases: inflammatory diseases (rheumatoid arthritis, Crohn’s disease), endocrine disorders (hyperthyroidism, type 1 diabetes), intestinal malabsorption disorders.

📋 Good to know — A fracture following minor trauma, such as a simple fall from standing height or an everyday movement, may be a symptom of bone fragility.  

Bone densitometry and menopause: what is the link?

Menopause is the main factor behind bone loss in women. The sharp drop in estrogen leads to accelerated bone resorption, sometimes on the order of 2% to 3% per year in the first years following menopause.

That is why postmenopausal women are the group most often referred for bone densitometry. The earlier menopause occurs (before age 45), the higher the risk of bone loss and the more justified early screening becomes.

📋 Good to know — Surgical menopause (removal of the ovaries) causes a sudden drop in estrogen that is more pronounced than natural menopause. It is a major risk factor for osteoporosis and warrants close follow-up.

Can you get a bone density scan without a prescription?

A medical prescription is required to have a bone density scan, as with any other imaging test. Your doctor determines whether the test is appropriate and writes the prescription with the necessary clinical information.

This rule applies even to tests not covered by RAMQ. A health insurance card is requested for all patients, including for private exams, for identification and record-keeping purposes.

At Radiologie Dix30 clinic in Brossard, the test is performed with a medical prescription. You can visit our bone densitometry page for full practical details on preparation and how the exam is carried out.

How often should you have a bone density scan?

RAMQ covers bone densitometry once a year. This frequency is appropriate for most clinical situations. It makes it possible to monitor changes in bone density over time and assess how effective osteoporosis treatment is.

Outside of treatment follow-up, your doctor determines the monitoring schedule best suited to your situation.

Radiologie Dix30 clinic welcomes you in Brossard, on Montreal’s South Shore, 365 days a year. Send your prescription by fax to 450-904-0405 or by email to info@radiologiedix30.com to schedule your appointment.

Sources

Collège des médecins du Québec. Clinical Prevention Sheet — Adults (updated February 2025). https://cms.cmq.org/files/documents/Fiches/fiche-prevention-clinique-04.pdf

Canadian Task Force on Preventive Health Care. Recommendations on screening for primary prevention of fragility fractures (2023). https://canadiantaskforce.ca/lignesdirectrives/lignes-directrices-publiees/fracture-de-fragilisation/?lang=fr