Common errors in dual-energy x-ray absorptiometry (DXA) examinations: insights from a cross-sectional study in Northeastern Brazil

Introduction: Common technical errors in dual-energy X-ray absorptiometry (DXA) exams may compromise diagnostic accuracy. This study aims to analyze the frequency and types of those errors in DXA scans performed in a referral center. Material and methods: This cross-sectional study evaluated 100 DXA exams performed at multiple radiology clinics and analyzed at the General Outpatient Clinic of the Medical Residency Program in Endocrinology and Metabolism at Alcides Carneiro University Hospital (HUAC), in Campina Grande. Exams were assessed for technical errors, including improper positioning, vertebral exclusion, and inaccurate region of interest (ROI) definition. Patient demographic data (age, sex, body mass index) were also collected. Descriptive statistics were used to summarize patient characteristics and the frequency of errors. Results: The study population had a mean age of 65.6 years (± 10 years), with a predominance of female patients (95%). The mean BMI was 26.4 kg/m² (±4.8 kg/m²). Regarding ethnicity, 91% of the sample identified as white. A total of 76% of exams presented at least one technical error, with the most common being osteophyte presence (64%), inadequate femoral rotation (45%), and incorrect ROI (35%). Only 24% of the exams were free of errors. Conclusions: These findings highlight the need for systematic training and strict adherence to imaging protocols to improve diagnostic accuracy and patient outcomes.