The Bone Scan You Already Had

One of my main goals as an osteoporosis provider is to get people screened sooner and earlier, so that a fracture is never the first sign of a problem. That is why we formed Demand the Scan™, to help women advocate for earlier screening for osteoporosis. A 2025 study in JACR points to a way to reach more people earlier, using something that's been sitting in plain sight: the CT scans patients already have.

Researchers looked at nearly 2.9 million Medicare beneficiaries from 2015 to 2022. Only 20.2% had a DXA scan. But another 22.7% who had not yet had a DXA did have at least one CT that included the L1 vertebra, the very bone we can use to estimate bone density.

The math is striking. Reading noncontrast CT alone would raise the screening rate by 76%. Using all CT studies would raise it by 113%. That is not a new machine or a new appointment. It is information we already captured, going unused.

The cost picture is just as compelling. If any CT was used and eligible patients were treated, the authors estimate potential annual cost avoidance of roughly $100 million in the study population, and $2.5 billion across all 2023 Medicare fee-for-service beneficiaries.

I'll be honest about the limits. These are modeled projections built on billing data. A flag is not the same as a holistic treatment plan. However, it is definitely a start, and anything that allows us to discuss bone health sooner, before the first fracture, to me is a win.

This is prevention hiding in existing images. If you've had a CT of your abdomen or spine for any reason, it's worth asking whether your bones were part of the read.