Referral Guidelines for Bone Mineral Densitometry scans (DXA) for the Osteoporosis Service
Referring to us
Referrals for a DXA scan can be accepted from either Consultants within the Sherwood Forest Hospitals Trust or via GP’s, but they need to have undertaken appropriate training and be an authorised referrer.
For both of these referrer groups there must be Clinical indications for the request for a DXA scan.
Please see further down the page for information about the referral process.
The age group for a DXA scan is 18 years and over.
Bone Densitometry
This is the use of a dual energy X-ray absorptiometry to establish bone mineral density of individuals considered to be at risk of having or developing Osteoporosis.
Bone Mineral Density measurement by DXA at the lumbar spine and proximal femur remain the current gold standard for the diagnoses of patients with osteoporosis and these are the scans that are currently undertaken within our service.
We would also perform a DXA scan at the wrist for following patients: hyperparathyroidism patients, bilateral hip replacements, and also if a patient has a metal rod in the spine.
The DXA scanner is used to establish an individual’s bone mineral density in order to confirm diagnosis of osteoporosis.
The scan results would be used as a guide for identifying correct treatment and advice for each individual.
Scanning would also be used to review effectiveness of treatment and also development of osteoporotic disease.
Referral process
GP’s and Consultants can request a DXA scan on the ICE system, completing the reason for the scan to be undertaken. It is important that all relevant information is included especially with regard to the patients mobility for being able to get on and off the scan table, therefore if you do need assistance or require transfer aids (rotunda or hoist) it is beneficial to inform the referrer of this.
The DXA scan request will then be assessed by one of the operators who will either accept or reject the referral. The operator will need to give a reason for rejecting the referral and it is then the responsibility of the GP/Consultant to inform the patient of the rejected request and re-refer appropriately if needed.
A confirmation letter detailing a DXA scan appointment will be sent to the patient from the Admin team at Mansfield Community Hospital, which will include the “Having a bone mineral density scan” leaflet and a lifestyle questionnaire. It is very important that the lifestyle questionnaire is completed, including current medications, as this is part of the assessment process and will help guide advice and treatments following the DXA scan.
Reporting of DXA scans
The Osteoporosis Nurses will assess the lifestyle questionnaire and DXA scan results.
A report will be sent out to the GP who requested the DXA scan which will be authorised by the Consultants of the service.
For Consultant referrals, a report will be sent out to the referrer unless further assessment is required in the form of an outpatient appointment (OPC).
Private patient referrals
Referrals for private patients are accepted but there must be a risk factor identified prior to any DXA scan being performed.
The patient will still need to obtain a referral request from either their GP or Consultant which must be marked “Private Scan”. This will then be triaged by the Osteoporosis team and an appointment sent to the patient if justified.
When the patient attends for their DXA scan they will be asked to sign the “undertaking to pay in respect of private health care” form, in order for payments to be sought.
A copy of the DXA scan results will then be given to the patient.
