Screening for Osteoporosis: Who Needs a Bone Density Scan and When?

Osteoporosis is called the "silent thief" because you can't feel your bones getting weaker. Find out if you qualify for a Bone Density scan in Ontario and how often OHIP covers it.

You go for your annual check-up, and your doctor mentions checking your cholesterol or your blood pressure. But when was the last time you checked your bones?

Osteoporosis—a condition where bones become porous and fragile—is known as the "silent thief." It steals bone mass without any symptoms until the day you slip, fall, and suffer a fracture. In Canada, fractures from osteoporosis are more common than heart attack, stroke, and breast cancer combined.

The good news? It is preventable and treatable. The first step is screening with a Bone Mineral Density (BMD) scan, also known as a DEXA scan.

At Frontier Diagnostics in Guelph, we often hear patients ask: "Am I old enough for this test?" or "Why can't I have one every year?" Here is the simple guide to who needs screening and when.

Who Needs a Bone Density Scan?

In Ontario, guidelines are specific about who should be screened. Generally, patients fall into two categories:

1. The "Age-Based" Group (Seniors)

Age is the biggest risk factor for bone loss. As we get older, our bodies naturally lose bone faster than we can rebuild it.

All women and men age 65 and older should have a baseline bone density scan.
Some newer guidelines suggest starting at age 70 if you have absolutely no other risk factors, but most physicians in Ontario will begin screening conversations at 65 to establish a baseline.

2. The "Risk-Based" Group (Under 65)

You don't have to be a senior to have weak bones. Men and women under age 65 (usually aged 50-64) should be screened if they have specific "High Risk" factors.

You may qualify for a scan under age 65 if you:

Have had a "Fragility Fracture": This is a broken bone from a minor incident, like falling from standing height or less.
Take High-Risk Medications: Specifically steroids (like Prednisone) for more than 3 months, or certain cancer drugs (aromatase inhibitors for breast cancer or androgen deprivation therapy for prostate cancer).
Have a Parental History: Did your mother or father fracture their hip? This is a major genetic risk factor.
Smoke or Drink Heavily: Current smokers and those who consume 3+ alcoholic drinks per day are at higher risk.
Have Specific Medical Conditions: Such as Rheumatoid Arthritis, Celiac Disease, or Malabsorption syndromes.

"When" Can I Get Scanned? (Understanding OHIP Frequency)

One of the most confusing parts of bone density screening is frequency. Unlike a blood test, you cannot simply get a DEXA scan every year "just to check."

OHIP has strict rules on frequency based on your risk level.

1. "High Risk" Patients: Every 12 Months

If you are deemed "High Risk" by your doctor (e.g., you are actively taking osteoporosis medication, or you are on long-term steroids), OHIP covers one scan every year (specifically, 1 year plus a day).

2. "Low Risk" Patients: Every 3 to 5 Years

If your first scan showed normal bones or only mild bone loss (Osteopenia), you are considered "Low Risk."

OHIP typically covers a second test 36 months (3 years) after your baseline.
After that, if your bones remain stable, coverage generally shifts to once every 60 months (5 years).

Why wait so long? Bone loss is a slow process. Scanning every year for a healthy patient is like watching grass grow—changes are too small to see, and the results won't change your treatment plan.

What Does the Scan Involve?

If you qualify for screening, you will be relieved to know it is likely the easiest medical test you will ever do.

It is Painless: No needles, no injections.
It is Fast: The appointment takes about 15-20 minutes.
It is Safe: The radiation dose is extremely low—less than a standard chest X-ray.

Protect Your Future Mobility

If you are over 65, or if you are over 50 with risk factors, don't wait for a fracture to tell you your bones are thinning. Talk to your doctor about a requisition for a Bone Mineral Density test.

Frontier Diagnostics in Guelph accepts all valid requisitions. Click here to book your screening today.

This blog is for general information only and isn’t intended to be medical advice. Please consult a healthcare provider for any questions or concerns about your own health.