REMS (Echolight) Scan - anyone?

Is this your first DEXA? Personal trends are critical.
I’ve had DEXAs over the last twenty years, and the results show consistently declining results, especially with the lumbar, which is now a T-score of -3.7. The femurs have been stable over the last three tests at -2.1, Like you, healthy, active, no fractures, with insistence from doctors to start medication, which I have resisted so far, but am open to. I also had a REMS within a month of this latest DEXA, and the results were confusing. The REMS showed a lumbar T-score of -1.8 and femurs at -2.5 and -2.3. In addition the fragility score was 42.1 which is abysmal. So ……do I want to believe the REMS for my spine and the DEXA for the hips? You bet! Would I rather trust my frax from the DEXA than the fragility score from the REMS? Yep. But it’s not logical to compare the two tests in the first place, because they are completely different technologies. Some experts say the REMS is more reliable, others not. The naturopath who discussed my results with me only looked at the Zscores, which were not even osteopenia, and said to ignore the T scores and fragility score, so where do I put that?!
My gut tells me the DEXA is likely pretty accurate since it’s consistent, but I will repeat the REMS in a year or so to see if there is a decline with those results too. In the meantime, I keep trucking along with supplements, resistance training, running, and lots of questioning and researching. Is the REMS worth the trip and expense? It was for me, even with the doubt, because I would still be wondering and more info, even conflicting, is better in my mind.

Oh my goodness, that sounds confusing and I will also want to believe the best scores from either scan. Thank you for taking the time to write.
By the way, I found a place in Vancouver after reading a post somewhere that the person had a scan in Vancouver. I've booked a REMS scan for Thursday. I also have my 2nd DEXA booked in June but it's a different clinic at a hospital this time as my doctor wants to get me into the "system". My first scan I paid for privately 6 months ago, I then panicked and had a Reclast infusion.
My Naturopath recommended HRT and was OK with the fact that I had a Reclast infusion, although she may have spoken differently if I had met with her before having it.

I'm so glad to hear that you are running! I was told not to run, jump or fall. Pretty limiting!
It was a weird feeling that I had in my lumbar spine when doing jumping jacks that led me to book my first DEXA (MD would not send me, too young). Needless to say that I don't do jumping jacks anymore. I do weight training, yoga and long dog walks, no more boot camps! 🙂

Thanks again for taking the time to share your journey .

I’ve had three doctors and two physical therapists tell me to keep running. That being said, I’ve been running for years, so it isn’t new for me. I’ve reduced it a bit to faster walking, but I think it’s the reason my hips have stayed stable. Doesn’t do too much for spine, I don’t think. If I was your age, I think I would investigate HRT, but I’d be very careful to find a doc who truly specializes in that area. Probably just as difficult as finding a good one who specializes in osteoporosis!

On another note, if you are able, try to get a vertebral fracture assessment with your DEXA. It’s a low resolution xray of your vertebral column done with same DEXA equipment. I was so happy to see my normal size vertebral bodies with good spacing that I didn’t worry as much about my T score! But like the TBS, not all imaging centers do them.

Just had echolight R.E.M.S. done at Central Carolina Orthopaedics last week. I highly recommend Dr. Bush. The BMD without technician errors (incorrect area of interest, bad positioning) and without influence of osteoarthritis and bone spurs or curvature of spine or my low weight 120 pounds was well worth the cost and travel time. Not to mention R.E.M.S. superior ability to predict fracture compared to Dexa…made it a go to for me. I still have low BMD however this is not the best predictor of fracture or bone strength. I was ready to begin Tymlos and now have been advised against it because of fragility scores in the green. WHO said I had high risk of fracture according to T scores, not true! Next I have found a reliable Dexa with TBS in Raleigh NC that will give additional bone quality info so I will post after that. Look at latest research on R.E.M.S.! The Dexa doesn’t give the whole picture on bone strength. Soon the R.E.M.S. will tell about muscle sarcopenia too. The bone and muscle are a unit. Build muscle and the bones will strengthen. Keith McCormick’s Great Bones book has chapter on Dexa and you tube videos on Dexa errors helped me want to know more before getting on the medicine train! I recommend quality Dexa, getting print out with color images so you too can see more than the T scores. Preferably find a Dexa with TBS or echolight R.E.M.S. so you get information on bone quality and strength. Good luck everyone. My heart is with you. The new technologies will help all of us.

I recently had a REMS which was well worthwhile after 3 previous DEXA scans over 5 years. I have no doubt at least one of my DEXA spine scores was way off showing a .4 improvement after a year, from -2.8 to -2.4, on high dose Prednisone with minimal exercise! How could that be possible! My REMS spine T score showed a .5 improvement recently from -3.5 on DEXA to -3.0 6 months after the DEXA. I recommend looking at the REMS Facebook discussion group where you will find detailed instruction on how to read the REMS scores. My fragility score was 39.3 which is still on the edge of the low fracture risk green zone on the graph. It is important to keep in mind that the 5 year risk of an osteoporotic fracture is presented as a number out of a 1000 and not 100, so the score can be divided by 10 to get the percentage. My 5 year spine fracture risk was 35-60, so 3.5 - 6.0 percent risk of fracture. Your REMS spine T score of -1.8 from DEXA -3.7 raises questions for sure. I guess only another REMS and DEXA might provide answers. I will have another DEXA and REMS in 6 months to compare again, but I am relieved by the fragility score and 5 year fracture risk results of the REMS and glad to have the .5 spine improvement on REMS to compare with the DEXA.

Andrea, Am I understanding correctly that you found a REMS clinic in Vancouver? That would be much easier for me than the trip to Calgary.

I've recently started going to an Osteo-Strong location near me and several times a year they bring in a REMS scan/Echolight, and it's open to the public (you don't need to be an Osteo-Strong member to have the scan). I had my first DEXA a few months ago and I'm going to do an Echolight scan next week, just to have a baseline because I understand it may provide some additional insight into my bone density. I like that the Echolight does not use radiation.

I'd love to hear what you find out. I'm having one on Thursday.
Thanks!

I did, I will email you. 🙂