The Best Imaging Tests to Assess Osteoporosis


The first step to assessing your bone health risk is receiving the proper imaging. Rates of screening for Osteoporosis are declining and only ~10% of those who should be screened end up getting the appropriate testing.

This conversation provides an update on imaging for osteoporosis, highlighting the limitations of DEXA and the importance of screening for bone health. The challenges in screening for osteoporosis are discussed, along with the criteria for bone density screening. Different imaging methods, including DEXA, trabecular bone score (TBS), quantitative CT, and Echolite REMS ultrasound, are explored, with their respective limitations and benefits. The importance of understanding bone quality and strength is emphasized. The conversation concludes with recommendations for screening and treatment.

4 Imaging Tests for Osteoporosis: 

  • DEXA
  • DEXA with TBS
  • Echolite REMS
  • Dynamic CT


  • DEXA is the gold standard for measuring bone density but does not provide information on bone quality.
  • Screening for osteoporosis is important, especially considering the increasing prevalence of low bone density and the younger age at which osteoporosis is developing.
  • Trabecular bone score (TBS) and quantitative CT provide additional information on bone architecture and quality, but have limitations.
  • Echolite REMS ultrasound is a promising imaging method that measures both bone density and quality, and may be more accurate than DEXA.
  • Understanding bone strength and creating a proactive plan for treatment is crucial in managing osteoporosis.

Additional Resources