Yes, you can have a DEXA scan with metal implants. A Harvard-affiliated patient guide to DXA says the implants will show up on the scan, but the test can still be done without pain or problems. What changes is which body area the technologist measures and how the results are read. A hip replacement or spinal hardware can make that region unusable, so the clinic scans another site instead.
TL;DR
- Metal implants do not rule out a DEXA scan. They can make the implanted region unreadable, so the clinic measures somewhere else.
- Tell the front desk and the technologist about any replaced joint, rod, screw, pin or clip when you book, and again on the day.
- If a hip or the lumbar spine can't be evaluated, the usual fallbacks are the other hip, the remaining vertebrae or the non-dominant forearm.
- Wear clothing with no metal or hard plastic, and leave jewelry and watches at home.
- The radiation dose is very low, and implants do not make the scan unsafe.
Table of Contents
- Why metal matters on a DEXA scan
- Which implants cause problems, and which usually don't
- What happens when your hip or spine can't be read
- What about body composition scans?
- How to prepare when you have an implant
- Is it safe with implants?
- What a good scan day looks like with metal
- Our perspective
- Find a clinic that can scan around your implant
- When a bone density scan is worth getting after surgery
- FAQ
- Sources
Why metal matters on a DEXA scan
A DEXA (also written DXA) scanner sends two low-energy X-ray beams through your body and measures how much each one is absorbed. Bone absorbs more than soft tissue, and that difference lets the software estimate mineral density or separate fat from lean mass. Metal absorbs far more than bone does. When a titanium plate or a stainless steel rod sits in the scan field, the software sees something much denser than anything in a normal skeleton.
The result is what clinicians call an artifact. A review of DXA artifacts in the 2024 updated practice guideline notes that artifacts, including hip replacements and spine surgical implants, can limit or impede interpretation of the spine or hip scan. In practice, that means the number the machine reports for the implanted area may not reflect your real bone.
That is why the scan is not refused but is handled differently. The technologist's job is to spot the metal on the image, decide whether the region can be used and, if not, take it out of the analysis or move to another site. The ISCD best practices paper stresses that accurate interpretation depends heavily on the technologist recognizing and managing artifacts such as metal.
Which implants cause problems, and which usually don't
Not every piece of hardware matters equally. What counts is whether it sits inside the area being measured.
| Implant or hardware | Where it matters | What typically happens |
|---|---|---|
| Hip replacement | Hip scan | That hip can't be assessed; the other side is scanned |
| Spinal fusion, rods, hooks, screws or cement | Lumbar spine scan | Affected vertebrae are excluded from analysis |
| Knee replacement, ankle or foot hardware | Usually outside hip and spine fields | Often not in the scan field for a bone density test, but tell the technologist |
| Pins or plates in the forearm | Forearm scan | A different forearm or another site is used |
| Surgical clips, stents, pacemakers | Depends on position | The technologist checks the image and decides |
The table is a general guide, not a verdict on your case. The technologist decides on the day, from the image, what can be used. Two points in it come straight from clinical guidance. The 2024 guideline says vertebrae affected by surgical hardware, such as fusion material, rods, hooks or cement, are often excluded to avoid inaccuracies, provided at least two evaluable vertebrae remain for classification. It also says that if one hip is not evaluable, for example because of hip arthroplasty, the other side should be assessed. Both are in the updated practice guideline.
What happens when your hip or spine can't be read
There is a clear fallback sequence, and it keeps the scan useful.
- Scan the other hip. If you have one replaced hip, the native hip is measured.
- Use the remaining vertebrae. In a spine with fusion hardware, the technologist leaves out the affected levels and reads the rest, as long as enough vertebrae are left to classify.
- Move to the forearm. When both hips or the spine are compromised, the guideline says a non-dominant forearm scan should be considered. The same source says the technologist may choose an alternative area such as the non-dominant forearm so results remain useful (Slart et al., 2024).
So the honest answer to "will the scan still tell me anything?" is yes. The forearm result is a different measurement site from the hip and spine, which is worth remembering when you compare numbers. If you are following your bone density over time, ask for the same site each time. The ISCD's official positions also highlight consistent patient positioning as important for precise bone density and body composition measurements, and the same logic applies to using the same site.
For what the T-scores and Z-scores mean once you have them, our guide to reading DEXA results walks through it step by step.
What about body composition scans?
Many people with a knee replacement, a plate in an arm or a spinal rod want a body fat scan rather than a bone density test. A whole-body scan covers the whole skeleton, so some hardware will be in the field. The research we have checked focuses on bone density sites, and it doesn't give a figure for how much a given implant shifts a body fat percentage. So the practical step is to tell the clinic about every implant before you book and ask how their technologists handle it. A good clinic will look at the image, note where the metal is and tell you how to interpret the report.
If you are tracking progress, the larger point is consistency. Same clinic, same machine, same time of day and similar hydration make your repeat scans comparable. Our DEXA timing guide covers how far apart to space them, and the body composition scan page shows what the scan reports and what it costs.
How to prepare when you have an implant
Preparation is short, and most of it is communication.
Tell people early and tell them twice
The MGH patient guide advises telling the imaging team if you have metal in your body, such as a replaced joint or a pin in a bone (MGH DXA patient information). Do it when you book, so the clinic can confirm it offers the right scan sites, and again at check-in so it is in the technologist's notes. A detailed patient history, including prior surgery that could affect measurement accuracy, is needed to perform and interpret DXA correctly, as a technologist-focused quality article points out.
Helpful details to have ready:
- Which joint or bone was operated on, and which side
- Roughly when the surgery was done
- Whether there is hardware in your spine, and how many levels were fused, if you know
- Any earlier DEXA reports, so the clinic can pick the same site again
Dress for the scan
The same guide says to arrive free of metal and hard plastic, or be ready to change. That includes removing jewelry, watches and bras with clasps or underwire. Pick clothes with no zippers, snaps or metal buttons, such as stretchy pants and a plain top. Your implant stays where it is, of course. This is about keeping extra metal out of the image so it doesn't add to the confusion.
Check what else you've had recently
If you have had a contrast study or swallowed barium, the MGH guide advises avoiding elective scans within 2 weeks of the appointment where possible. Mention any recent imaging when you book. Nuclear medicine tests or contrast CT can also come up on a clinic's intake form, so answer those questions fully.
Is it safe with implants?
The implant does not change the safety picture. A whole-body DEXA scan gives a very low radiation dose, comparable to what you receive during an airplane flight, according to the MGH patient guide. Health New Zealand's bone density scan page simply calls the test very safe. Our own explainer on DEXA radiation puts the dose next to a chest X-ray if you want the numbers.
DEXA is not an MRI, so there is no magnet to worry about with implants. The scan uses X-rays, and the implant's main effect is on the image, not on you. If you are pregnant or may be, that is a separate question, covered in our post on DEXA scans during pregnancy. For any question about your specific implant, your surgeon or the doctor who manages your bone health is the right person to ask.
What a good scan day looks like with metal
A scan with implants should feel as routine as any other. Expect these steps:
- The front desk or technologist asks about implants, surgery and recent imaging.
- You change if needed and lie on the table. Positioning matters, so the technologist may adjust your legs or arms.
- The scan runs for a few minutes. Our scan duration guide breaks down how long each type takes.
- The technologist looks at the images. If they see metal in the hip or spine field, they may exclude regions or add a forearm scan.
- You get a report that should say which sites were measured and which were excluded.
Check that last point on the report. If the hip or spine section is blank or marked as excluded, that is expected, and it should be clear what site the numbers come from. The full DEXA procedure walkthrough shows the rest of the visit.
Our perspective
We built Dexascans around one idea: people should be able to find a clinic, see the cash price and book without a referral. Implants are the kind of detail where that matters. Someone with a replaced hip who wants a bone density test shouldn't have to guess whether a clinic can handle it, or arrive to find that only one site is offered.
That's why we encourage you to call or message a clinic before you book and describe your implant in plain words. Ask three things: which sites will you scan, can you add a forearm if my hip or spine can't be read, and will the report show which sites were excluded. Clinics that do this work every day will answer quickly. A technologist who knows how to handle metal artifacts is what turns a hardware-complicated scan into a useful one, and that skill is exactly what we look for when we verify listings.
We also think a scan with a fallback site is not a second-class result. It is the guideline-supported way to get a real measurement when the usual site is blocked. Treat it as your baseline, and have the next one done at the same site and clinic so the comparison means something.
— Erik
Find a clinic that can scan around your implant
Dexascans lists verified DEXA locations across the U.S. where you can compare cash prices and book directly, with no physician referral. Search by city or ZIP, check which scan types each clinic offers (bone density, body composition or a combined appointment) and send your implant details with your booking request.
For osteoporosis screening, start with our bone density test page, which covers costs and T-scores. For fat and lean mass tracking, use the body composition scan page. If you are in Colorado, you can also compare options on our Denver DEXA clinic listing.
When a bone density scan is worth getting after surgery
Many people with implants had them because of a fracture or joint wear, and some of those people have thin bones too. If you've broken a bone and wonder whether a bone density scan is warranted, our article on bone density after a fracture explains the timing and what doctors look for. For routine screening age ranges and Medicare's schedule, see the bone density test guidelines.
If you're an athlete or lifter with surgical hardware from an old injury, our post on using DEXA for bodybuilding covers what the scan tells you about lean mass and what it doesn't.
FAQ
Can I get a DEXA scan with a hip replacement?
Yes. The replaced hip will show as metal and can't be measured reliably, so the technologist assesses the other hip. If neither hip is usable, a non-dominant forearm scan is the recommended alternative (2024 practice guideline).
Does spinal fusion hardware ruin a bone density scan?
Not necessarily. Vertebrae affected by rods, hooks, screws or cement are often excluded from the analysis, and the rest can be read as long as at least two evaluable vertebrae remain. If the spine can't be used, the hip or forearm is measured instead.
Do I need to remove my implant or any jewelry?
No implant is ever removed. You do need to take off jewelry, watches and bras with clasps or underwire, and wear clothing without metal or hard plastic, per the MGH patient instructions.
Will my results be comparable to a scan without implants?
They are comparable only for the same site. A forearm result is not the same measurement as a hip or spine result, so repeat scans should use the same site, ideally on the same machine and at the same clinic.
Is a DEXA scan safe if I have metal in my body?
Yes. The dose is very low, similar to an airplane flight, and the scan has no magnet. Tell the technologist about your implants so they can read the images correctly.
Sources
- Dual Energy X-ray Absorptiometry (DXA) patient guide, Massachusetts General Hospital
- Updated practice guideline for dual-energy X-ray absorptiometry, PMC
- Official Adult Positions, ISCD
- Best Practices for Dual-Energy X-ray Absorptiometry, ISCD
- Improving DXA Quality by Avoiding Common Technical and Interpretive Errors, Journal of Nuclear Medicine Technology
- Bone density scan (DEXA), Health New Zealand