The National Institute for Health and Care Excellence (NICE) recommends that doctors carry out a direct examination of the spine during routine bone scans to detect osteoporosis problems earlier. This additional check only takes a few minutes and helps to identify serious painful spinal fractures later in life. An estimated 70% of spinal fractures caused by osteoporosis go undiagnosed because they often have no obvious symptoms at first. Hidden spinal fractures affect approximately 2.2 million people. In the draft guidance, NICE advises doctors to consider these checks during dual energy X-ray absorptiometry (DXA) bone mineral density measurements. This practice is cost-effective for people over 50.