Accuracy of DEXA Scans

Summary would not allow me to photo or share link so copy/paste 😊

Lol, Norma, good for picking the right finger!!!

Exactly, there are so many variables, and of course physical activity can cause injuries. I'm concerned with my hip, so I need to decide.

BTW, the price of this test was crazy high, I was shocked, nearly $900.

What test are you referring to that cost $900? A DEXA scan?

I agree with your inference - I can’t quite make out how they came to their conclusion that one score fits all. Did you read the NIH link? - I’m not positive I caught all the info. It seemed they put more focus on whether the standard deviation, based on a 30 yo white female, could be applied to men (with larger bone mass). It also seemed that they recognized that the individual bone mass was different - I can’t help but feel it was implied that the physician would make a clinical decision on what “normal” was and adjust their treatment plan accordingly. Normal meaning an average sized white female - and if the patient is larger, smaller, different race, the score would be expected to be different. But I’m afraid that is not what is happening in a typical PCP or endocrinologist office.

The FRAX score is usually used as part of decision making for BMD treatment.
https://frax.shef.ac.uk/FRAX/tool.aspx?country=9
I find this a rather simple tool. It is also dependent on knowing whether there has been a previous fracture. My mother had undiagnosed spinal compression fractures that did not get diagnosed until the pain increased. Perhaps the tool is meant to capture clinically relevant fractures only.

My FRAX score barely met criteria for treatment. And based on my thinner bone, I may have had only osteopenia not osteoporosis. But, for me, the breast cancer metastasis issue is now a factor. And it pushes me over into taking Reclast infusions- at least until the risk of invasive cancer is lower.

I have a T score for my lumbar spine, one for my femoral neck and one for total hip. Do you know which one I should enter into the FRAX tool?

Interesting article. Regarding Bisphosphonates, "175 women must be treated for three years for each hip fracture prevented. Conclusion: The dominant approach to hip fracture prevention is neither viable as a public health strategy nor cost effective. Pharmacotherapy can achieve at best a marginal reduction in hip fractures at the cost of unnecessary psychological harms, serious medical adverse events, and forgone opportunities to have greater impacts on the health of older people. As such, it is an intellectual fallacy we will live to regret."

@riley which "pharmacotherapy" does that article refer to? And was this article clear on the T scores in the study? Does it mention efficacy in the spine? What is the date for that and does it predate better meds now available?

I remember reading something like that years ago and ideas like that probably contributed to reducing urgency for getting on meds (I did try) and to my ultimate fractures.

As @riley said, the number is for bisphosphonates and is from 2019.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800121/#:~:text=Oral%20bisphosphonates%20are%20often%20considered,hip%20fracture%20is%20approximately%20200.

I need my glasses!

I remember reading that a few years back, probably before I went on Tymlos. I hope fewer doctors are prescribing bisphosphonates for osteopenia and early osteoporosis, and also that more doctors are starting with bone builders for more severe osteoporosis- if insurance will cooperate.