Dual energy X-ray absorptiometry (DXA) measurements of spine and hip bone mineral density (BMD) (referred to here as central DXA) have an important role as a clinical tool for the evaluation of individuals at risk of osteoporosis, and in helping clinicians give advice to patients about the appropriate use of antifracture treatment. Compared with alternative bone densitometry techniques such quantitative computed tomography (QCT), peripheral DXA (pDXA) and quantitative ultrasound (QUS), central DXA has a number of significant advantages that include a consensus that BMD results can be interpreted using the World Health Organization (WHO) T-score definition of osteoporosis, a proven ability to predict fracture risk, and proven effectiveness at targeting antifracture treatments. This review article discusses the evidence for these and other advantages of central DXA, including its role in the new WHO algorithm for treating patients on the basis of individual fracture risk.

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