Scanner-related: Ensure proper scanner function, image acquisition, and data analysis

Examination-related: Perform regular calibration, phantom scans, and consistent monitoring of control data to detect variability

Requesting DXA in low-risk individuals without clinical justification

Failing to screen high-risk patients who could benefit from early osteoporosis or fracture risk detection

Demographic data errors: Inaccurate entry of identifiers (sex, age, race)

Patient positioning: Misalignment of spine or hip, excessive rotation, or incomplete anatomical coverage

Skeletal abnormalities: Scoliosis or vertebral fractures may distort BMD values and require exclusion of affected vertebrae and careful interpretation

Artifacts: Metallic objects, clothing components, or retained materials (e.g., barium, implants) can impair image quality and accuracy

ROI placement: Incorrect placement may include/exclude bone or soft tissue, altering BMD values

Vertebral selection: Degenerated or fractured vertebrae must be excluded; errors compromise accuracy

Calibration/software: Poor calibration or processing errors can cause measurement inaccuracies

Misinterpretation of results or inappropriate clinical decisions based on inaccurate data analysis