Understanding your DEXA scan results
What the report actually shows, what a T-score and Z-score mean, and why the number is only one part of judging your fracture risk
A DEXA scan report can look unfamiliar at first, with scores and categories that are easy to misread. The good news is that the result is more straightforward than it appears, and a single label rarely tells the whole story. This guide explains what the report shows in plain language, what the scores mean, and why your bone density is only one part of a wider picture of your bone health and fracture risk.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). Last clinically reviewed: June 2026.
What the report shows
A DEXA scan measures the density, or strength, of your bones, usually at the hip and spine. The report turns that measurement into a score that compares your bones with an expected value, so that the result can be interpreted consistently. The two scores you are most likely to see are the T-score and the Z-score.
It helps to remember that these are comparisons, not a pass or fail mark. They tell a specialist how your bone density sits relative to a reference group, which is the starting point for a conversation about your bone health, not the conclusion.
Your T-score explained
The T-score compares your bone density with the normal range for a healthy young adult. It is the score most often used to assess for osteoporosis. The standard categories, as set out by UK sources such as the Royal Osteoporosis Society, are:
- Normal: a T-score between +1 and -1.
- Low bone density (osteopenia): a T-score between -1 and -2.5. This is slightly below the normal range for a young adult and is commonly seen as we get older.
- Osteoporosis: a T-score of -2.5 or below, meaning bone density is much lower than the normal range for a young adult.
Because the comparison is with a young adult, some reduction with age is entirely expected, which is one reason a T-score is read alongside your age and other factors rather than on its own.
Your Z-score, and when it is used
The Z-score compares your bone density with what would be expected for an adult of your own age, gender and ethnic background. Because bone density naturally changes with age, the Z-score can give a fairer comparison in younger people, and it is the score given more weight in younger adults, where a low result may prompt a look for an underlying cause.
As with the T-score, a lower Z-score points to a higher chance of fracture and may help guide whether treatment is considered. The aim is always to understand the result in your particular context.
The score is one part of fracture-risk assessment
This is the most important message of the guide. A DEXA score is not a verdict, and a label is not destiny. Bone density is just one ingredient in judging your risk of breaking a bone, which is the question that really matters. A fracture-risk assessment weighs the score together with things such as your age, any previous fractures, a family history of osteoporosis or hip fracture, long courses of steroid medication, smoking and alcohol, and your general health.
Tools such as FRAX are used as part of this assessment to estimate fracture risk, drawing these factors together, sometimes alongside a DEXA result and sometimes on their own. This is why two people with the same T-score can sensibly be given quite different advice: the number is read in the round, not in isolation.
What the follow-up conversation covers
Once your result is understood in context, the conversation turns to what, if anything, to do about it. For many people, particularly with osteopenia, this is about managing risk rather than starting medication: sensible exercise, a balanced diet, attention to calcium and vitamin D, and addressing factors such as smoking. A finding of osteopenia is a prompt to look after your bones, not an automatic reason for treatment.
Where bone density is lower or your overall fracture risk is higher, bone-protection medicines such as bisphosphonates may be recommended to strengthen the bones and reduce the chance of fracture. The treatment options, how they are taken and how progress is monitored are explained in full on the osteoporosis and bone health page. Whatever the result, the plan is agreed with you and matched to your own situation.
When to seek specialist review
If you have been given a DEXA result and are unsure what it means for you, a specialist review can explain it clearly and set out a plan. It is particularly worth seeking review if:
- Your scan shows osteoporosis, or osteopenia together with other risk factors
- You have broken a bone after a minor fall or knock
- You have taken long or repeated courses of steroid medication
- There is a strong family history of osteoporosis or hip fracture
- You are younger than expected for low bone density, where an underlying cause may need looking into
Dr Borukhson reviews DEXA results as part of a full bone-health assessment, explaining what your scores mean and agreeing the right next steps. If you feel unwell or have sudden, severe back pain, contact your GP or NHS 111 rather than waiting for a routine appointment.
Common questions
What does my DEXA T-score actually mean?
Your T-score compares your bone density with the normal range for a healthy young adult, and it is the score most often used to look for osteoporosis. As a rough guide, a T-score between +1 and -1 is normal, between -1 and -2.5 is low bone density (osteopenia), and -2.5 or below indicates osteoporosis. Because some reduction is expected with age, the number is best read alongside your age and other factors rather than on its own. A specialist can explain what your particular score means for you.
Does a low score or a diagnosis of osteopenia mean I definitely need treatment?
Not necessarily. Osteopenia, in particular, is often a prompt to look after your bones rather than an automatic reason to start medication, and for many people the focus is on sensible exercise, a balanced diet, and attention to calcium and vitamin D. Whether bone-protection medicine is recommended depends on your overall fracture risk, not the score alone. This is something to talk through and agree as part of a full assessment.
Is my fracture risk decided by the DEXA number alone?
No, and this is the most important point. Your bone density is only one ingredient in judging your risk of breaking a bone, which is the question that really matters. A proper assessment also weighs things such as your age, any previous fractures, family history, steroid use, smoking and alcohol, often using a tool like FRAX. This is why two people with the same T-score can sensibly be given quite different advice.
Should I see a specialist about my DEXA result?
It is well worth a specialist review if you are unsure what your result means, especially if your scan shows osteoporosis, or osteopenia together with other risk factors. A review is also sensible if you have broken a bone after a minor fall, taken long or repeated courses of steroids, have a strong family history, or are young for low bone density. Dr Borukhson reviews DEXA results as part of a full bone-health assessment, explaining your scores and agreeing the right next steps. If you feel unwell or have sudden, severe back pain, contact your GP or NHS 111 rather than waiting.
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