Please note that TBS is valid up to a BMI of 35

THE DEXA SCAN

A DEXA scan (DXA or Dual-Energy X-ray Absorptiometry) is the gold standard for
body composition analysis and is also used to evaluate bone density. This non-invasive,
clinically trusted technology measures lean muscle, fat distribution, and—when a bone
density scan is performed, it provides comprehensive information about bone mineral
density (BMD) and fracture risk. 
For individuals focused on bone health, DEXA bone density scans may
include Trabecular Bone Score (TBS), an advanced, clinically validated analysis that
evaluates bone microarchitecture (bone quality) in addition to bone density. Together,
BMD and TBS provide a more complete assessment of fracture risk than bone density
alone—without additional radiation or additional scan time. TBS is valid for clients with a
BMI of 37 or less.  
DEXA scans are ideal for athletes, fitness enthusiasts, and individuals focused on
overall wellness or bone health, providing accurate, actionable insights to support
informed decisions about fitness, nutrition, and long-term health. 

Key Benefits:
DEXA for BONE DENSITY (BMD) + TBS 
Bone mineral density is essential for detecting osteopenia and osteoporosis. However,
bone density alone does not fully reflect bone strength. TBS evaluates bone
microarchitecture, a critical component of bone quality, helping identify individuals at
increased fracture risk—even when bone density appears normal or borderline. 
DEXA for BODY COMPOSITION 
Muscle Mass: DXA provides precise lean muscle measurements by both percentage
and weight, allowing for accurate tracking of muscle balance and changes over time. 
Body Fat: 
DXA assesses total body fat and regional fat distribution (arms, legs, waist, and hips).
Many scans also include visceral adipose tissue (VAT), a key marker associated with
cardiometabolic health and type 2 diabetes risk.

 
Key evidence supporting “gold standard” claims: 

1. Bone density (BMD) — strongest evidence: DEXA is accepted worldwide
   as the standard method for measuring BMD and diagnosing osteoporosis; its
   outputs (T-scores) directly inform clinical decisions about fracture risk and
   treatment.
2. Bone microarchitecture (TBS) — enhanced fracture risk assessment: 
   Trabecular Bone Score (TBS) is a clinically validated index of bone
   microarchitecture derived from DXA images and evaluated alongside BMD.
   By assessing bone quality in addition to bone quantity, TBS improves fracture
   risk prediction and helps identify at-risk individuals who may not meet
   osteoporosis thresholds based on BMD alone. TBS adds this insight
   without additional radiation exposure or extended scan time and is supported
   by over 1,200 published scientific studies and inclusion in more than 30
   national and international clinical guidelines.
3. Precision and reproducibility: Multiple methodological papers and reviews
   document low measurement error and good inter/intra-scanner precision for
   BMD. These properties make DEXA ideal for longitudinal monitoring.
4. Body composition reference: In body composition research, DXA is widely
   used as the reference comparator against which Inbody, BIA,
   skinfolds, BodPod, and consumer devices are validated; many validation
   studies show BIA and other methods have wider limits of agreement vs DXA.
5. Comparisons to CT/MRI for fat distribution: CT/MRI remain true anatomic
   reference standards for visceral adipose quantification. DXA provides good
   whole-body FM and regional measures, but systematic reviews highlight
   limitations when quantifying intra-abdominal adipose tissue (IAAT) vs CT/MRI.
   Use DXA as a validated, lower-dose, more accessible reference for most
   clinical/research needs, but acknowledge when CT/MRI is required.
6. Population and athletic uses: For athlete monitoring and clinical
   populations, DXA’s segmental lean mass and regional fat measures
   are frequently recommended over simple field tests because they better
   capture body composition changes.

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