title: Dual-energy X-ray absorptiometry in clinical practice: new guidelines and concerns.
abstract: OBJECTIVE
  To summarize recent policy and guideline updates that have significant consequences for the clinical use of dual-energy X-ray absorptiometry (DXA) in the diagnosis and treatment of osteoporosis and, thus, the prevention of fractures and associated morbidity and mortality.
  
  
  RESULTS
  Recent policy trends have sought to reverse reimbursement declines for DXA services, whereas updated guidelines have attempted to restrict the candidates for bone density testing. Recent literature reflects the ongoing controversy of repeat DXA testing.
  
  
  CONCLUSIONS
  Patient access to DXA scans has been threatened by declining reimbursement and, therefore, access to diagnosis and fracture prevention. There have been successful efforts to reverse this trend, but the future remains uncertain. The complexities and omissions of updated guidelines for obtaining DXA testing may serve again to restrict initial access, and the recent controversy of repeat DXA testing may make monitoring results of therapy more difficult.
authors.affiliation: Division of Rheumatology, Allergy and Immunology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee 37203, USA. bobo.tanner@vanderbilt.edu
authors.forename: Simpson Bobo
authors.initials: SB
authors.lastname: Tanner
mesh_terms: D015502:Absorptiometry, Photon / Q000009:adverse effects / Q000191:economics* / Q000592:standards*; D006801:Humans; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000191:economics / Q000628:therapy; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging* / Q000191:economics / Q000517:prevention & control; D017410:Practice Guidelines as Topic / Q000592:standards*; D012051:Reimbursement Mechanisms / Q000191:economics / Q000639:trends