What is the best practice for scanning a pregnant patient with DXA?

• A. It is always safe to proceed
• B. Pregnancy is a relative contraindication; avoid unless clinically justified
• C. Use double shielding for protection
• D. Only scan during the second trimester

Answer: (B)

The best practice for scanning a pregnant patient with DXA is that pregnancy is a relative contraindication; proceed with caution unless there is a clear clinical justification for the scan. The use of DXA (Dual-energy X-ray Absorptiometry) involves exposure to a small dose of ionizing radiation, which can pose potential risks to the developing fetus. As a result, any decision to conduct a DXA scan on a pregnant patient should be carefully evaluated against the potential risks and benefits.

In many instances, the clinical need for assessing bone density may not outweigh these risks, leading to a recommendation to avoid the scan during pregnancy unless there are compelling medical reasons. Practitioners should consider the necessity of the scan, the potential risks involved, and discuss options with the patient to ensure informed decision-making.

The other responses do not convey the appropriate level of caution and clinical reasoning necessary for such a sensitive situation. For instance, assuming it is always safe to proceed ignores the potential risks associated with radiation exposure. Using double shielding, while a method for reducing exposure, does not mitigate the inherent risks of scanning a pregnant patient. Finally, limiting scans to the second trimester does not fully consider the complexity of each individual case, as any exposure could still pose risks regardless of