PEDIATRIC DEXA Protocol (rev. 2/17/2015)
For Patients Ages 5-19
For Patients Ages 5-19
1) Every patient must have a fully completed DXA questionnaire.
2) Know your DXA machines maximum weight capacity at your site and do not exceed it.
3) Each patient shall disrobe fully and be placed into a gown prior to scanning.
4) Remove all artifacts, if possible, prior to scanning (i.e. naval rings, bra clips, coins, buttons/snaps, etc)
5) Each patient shall have their weight and height taken by the technologist/nurse prior to scanning and entered into the DXA unit.
6) Make certain that the patient's age, sex, ethnicity and historical data are accurate and entered as appropriate into the DXA system.
7) Every patient should be scanned in "FAST ARRAY" mode as the primary mode of choice for both initial scans and follow up scans.
8) "ARRAY" mode and/or "EXPRESS" mode may be used, if needed only in those patients where you would not otherwise be able to complete the scan satisfactorily. (i.e. large patients where it is hard to see the site being analyzed, patients who can't hold still for the time necessary to complete scan etc.)
9) When able to do so, the PA spine and Total Body Bone Density BMC/BMD scan less head (TBLH) for purposes of assessing bone density and obtaining Z-scores will be done for each patient.
10) Hip scanning, forearm scanning, and lateral vertebral morphometry (i.e. LVA or IVA) are not done routinely unless otherwise directed by the interpreting PA/Densitometrist.
11) If the spine or TBLH can't be scanned for any reason (patient can't hold still, severe scoliosis, significant DJD, prior surgery, metal objects, patient overweight for table, etc) a note must be provided to explain this in Synapse under the "Notes" tab and/or call the reading PA/Densitometrist.
12) Total Body Mass Tissue Quantitation will be done for each patient, as soft tissue measures in conjunction with whole body bone density scanning is often helpful in evaluation patients that have chronic medical conditions.
13) BMI will be calculated by the interpreting PA/Densitometrist and added to the report/dictation for each patient.
14) Make certain that you perform a direct comparison to the most recent DXA scan for every anatomical area and/or region scanned before.
15) If the patient offers a confirmed history of hyperparathyroidism they must have both forearms scanned in addition to the aforementioned protocol.
16) Assure that all paperwork is filled out and this info is scanned into the system properly.
17) End and send all DXA scans efficiently.
18) Direct comparison of DXA scans from centers that have different DXA models, software and/or have not been cross calibrated should not be performed, as the precision error is too great for comparative data to be meaningful.
19) The DXA technologist will call the appropriate interpreting PA/Densitometrist, as designated on the physician schedule, when the case has been scanned and completed to assure that the scan is in fact complete, protocol has been followed, and no additional sites need to be scanned.