Can a DEXA Scan Detect Fractures?

Can a bone density (DEXA) scan detect fractures?

A standard bone density DEXA scan does not diagnose a broken bone — its job is to measure bone density and predict your risk of a future fracture, not to spot an acute break. If you have injured yourself and think a bone may be broken, a DEXA scan is the wrong test. According to the NHS, a bone density scan "uses low dose X-rays to see how dense (or strong) your bones are" and is "often used to diagnose or assess your risk of osteoporosis." NHS, Bone density scan (DEXA scan), 2022

There is one important exception. Where the service is available, a DEXA scanner can also run a Vertebral Fracture Assessment (VFA) — a separate image of the spine that can detect existing compression fractures in the vertebrae. So the honest answer is: a DEXA density scan predicts fracture risk, but the same machine can, with VFA, find spinal fractures that have already happened.

What is the difference between "detecting a fracture" and "predicting fracture risk"?

Detecting a fracture means finding a break that has already happened; predicting fracture risk means estimating how likely you are to break a bone in the future — two completely different questions. This distinction is the source of most confusion about bone scans.

• Detecting a fracture is diagnostic. Someone falls, their wrist hurts, and an X-ray confirms whether the bone is broken. The break already exists; the scan finds it.
• Predicting fracture risk is preventive. A bone density scan measures your bone mineral density (reported as a T-score) and feeds into a fracture-risk calculation. No bone is broken — the scan estimates the chance one might break over the next ten years.

A standard DEXA scan and our radiation-free REMS scan both sit firmly in the second category. They are risk-and-strength tools, designed to catch a problem before a bone breaks — not to diagnose one that already has.

Which scan actually diagnoses a broken bone?

A plain X-ray is the standard test for a suspected broken bone, with CT or MRI used for more complex or hard-to-see injuries. The NHS lists checking "your bones for a fracture after an accident" as one of the main uses of an X-ray. NHS, X-ray, 2026

If you are in pain after a fall or injury, the right route is urgent care or A&E for an X-ray — not a bone density appointment. A bone density scan measures strength across the whole skeleton; it is not designed to image a single suspected break in detail.

Can a DEXA scan detect spinal (vertebral) fractures?

Yes — where the service is offered, Vertebral Fracture Assessment (VFA) lets a DEXA scanner detect existing spinal compression fractures, and this matters because most of them are never otherwise diagnosed. VFA takes a lateral (side-on) image of the spine during the same appointment as the density measurement.

This is genuinely important. In a 2021 review in Osteoporosis International, researchers reported that 65–75% of vertebral fractures are clinically "silent," and only 30–40% ever come to medical attention. The same review found that in one hospital audit, of 132 vertebral fractures identified by expert radiologists, only 65 appeared in the radiology report and just 23 in the patient's record. Lems WF et al., Osteoporosis International, 2021

Spinal fractures are also one of the strongest warning signs of osteoporosis. A single vertebral fracture sharply raises the risk of further breaks — so finding a silent one can change your diagnosis and your treatment.

Why do so many spinal fractures go unnoticed?

Because most vertebral fractures are clinically silent — the 65–75% figure above — they build up over years without ever being diagnosed. Unlike a snapped wrist, a vertebra does not usually "crack" dramatically; it slowly compresses. The Royal Osteoporosis Society describes a spinal fracture as when "a bone in your spine becomes compressed or squashed after losing strength," and notes that people who break several bones in the spine "will probably lose some height" and may develop "an outward curve at the top of your spine." Royal Osteoporosis Society, Spinal fractures (vertebral fractures), 2026

That is why losing height as you age can be an early sign of osteoporosis rather than a normal part of getting older. If you have lost height, developed a stoop, or have unexplained back pain, it is worth discussing a bone assessment with your GP.

What does a standard bone density scan actually measure?

A bone density scan measures your bone mineral density and uses it to estimate your future fracture risk — it is a strength gauge, not a break detector. The result is usually given as a T-score, which compares your bone density to that of a healthy young adult. That number then feeds into fracture-risk tools such as FRAX, which combine your density with factors like age, sex and medical history to estimate your ten-year probability of breaking a bone.

If you want to understand how that risk figure is calculated, see our guide to fracture risk and the FRAX tool. The key point is that this is a forecast — the whole purpose is to act early, while there is still time to protect your bones.

Does a REMS scan detect fractures?

REMS estimates fracture risk and bone quality — it does not diagnose an acute break. REMS (Radiofrequency Echographic Multi Spectrometry) is the radiation-free technology we use at Screen My Bones. Like a DEXA density scan, it measures how strong your bones are and predicts your likelihood of a future fracture; it also gives a bone-quality score. It is a screening and risk tool, not a diagnostic test for a suspected broken bone.

What makes REMS well-suited to prevention is that it uses no ionising radiation, so it can be repeated safely to track your bone health over time. You can read the full detail on our REMS technology page. If you are worried about a break that has already happened, though, the right first step remains an X-ray through your GP or urgent care.

What a bone scan won't tell you

A bone density scan is a focused tool — it measures bone strength, so it won't diagnose other conditions people sometimes expect it to. Two common questions we hear:

• Will a DEXA scan show cancer? — A density scan is not a cancer screening test, and it is important to understand what it can and cannot flag.
• Does a DEXA scan show arthritis? — Arthritis can even affect the accuracy of a spine reading, which is worth knowing before your scan.

Understanding what a scan is for helps you choose the right test — and stops a normal bone density result from falsely reassuring you about an unrelated problem.

The bottom line

A standard bone density DEXA scan predicts your risk of a future fracture; it does not diagnose a broken bone. A plain X-ray does that. But DEXA-based VFA — and awareness of silent spinal fractures — means a bone scan still has a real role in finding fractures you never knew you had.

At Screen My Bones we offer radiation-free REMS bone-density screening to estimate your fracture risk and bone quality — the early-warning half of the picture. You can book a bone health assessment or learn more about our bone health assessment service. If you suspect a bone is broken right now, please see your GP or urgent care for an X-ray first.

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This article is general information about bone screening and is not a substitute for medical advice. If you think you may have a fracture, seek urgent medical care.