This case report describes the incidental detection of a significant pathology through careful visual inspection of a Dual-Energy X-ray Absorptiometry (DXA) scan rather than relying solely on bone mineral density measurements. An 88-year-old woman presented with right buttock and thigh pain accompanied by severe swelling. Although her symptoms were clinically suspected to be related to lumbar spine disease, only lumbar radiography and a DXA examination were requested without direct hip imaging. During the DXA examination, a femoral neck fracture of the right hip was incidentally identified on the acquired scan image. The attending radiologic technologist promptly recognized the abnormal finding and immediately communicated it to the orthopedic team through the Picture Archiving and Communication System. This case demonstrates that DXA images can serve as a valuable screening tool beyond bone mineral density assessment by compensating for potential diagnostic oversight and highlights the importance of meticulous image observation and proactive communication by radiologic technologists.