Can dexa scan detect osteomalacia?

Osteomalacia: No. A Dexa detects osteoporosis, or decreased amount of bone matrix. Osteomalacia is an abnormal type of bone, soft bones, abnormal building process. You can have both osteoporosis/malacia, so DEXA is still done in the workup to measure the amount of bone. Vit D deficiency, GI disorders that cause malabsorption, kidney disease, liver disease, certain drugs... all are part of the differential.

Yes and no.: A DEXA scan will generally be abnormal in the setting of osteomalacia, because osteomalacia results in decreased bone density. However, the DEXA scan can only detect the loss of bone density, it cannot by itself determine the reason for it. Correlation with clinical history and lab values is necessary.