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Hello, I joined today to get help in deciding what medication to begin
Osteoporosis & Bone Health | Last Active: Aug 11 10:11pm | Replies (70)Comment receiving replies
Isabelle,
DXA can't determine fracture. It only determines weak bone and possibility of fracture. While X-Ray delineates fracture, but can't determine osteoporosis. (although dxa is technically x-ray) Nice that they collaborated with CT. CT can sometimes detect hairline fractures not detected by X-Ray or even MRI which I'd prefer to the X-Ray, as more sensitive especially to current fracturing than X- Ray.
I'd be curious about the T-score at L-3 which may be measuring the smorls node and would be a lower score. And shouldn't be included in the total lumbar number -3.3 And maybe it isn't.
Smorls nodes are areas where the disc has displaced bone either because of a herniated disc or birth presence. Herniated discs can be painful. The nucleus of the disc is able to penetrate the bone because it is very acidic. Breeching the endplate with fracture or smorls makes the vertebra more vulnerable to further compression.
His spine has good alignment wherever you see not lithesis or retropulsion. Which is almost everywhere. There is a "subtle anterolithesis" of L3 on L4 (L3 is sliding slightly forward over L4). No pars is cited so that you know there is no fracture at the appendage on the back of the vertebra which can cause a vertebra to slide forward.
After a short period of concentration the terminology sets up an unnerving vibration in the ear. I'm thinking that this is enough. If you want more torture, I[m on call, even though I've no training.
Replies to "Isabelle, DXA can't determine fracture. It only determines weak bone and possibility of fracture. While X-Ray..."
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@gently
Thank you for your response. You said you'd be curious about the T-score at L-3. The only T scores I saw on the results were what I've posted above (lumbar, hip, neck).
I'm just learning about the Smorls nodes. I've never heard of them before. As I've never heard of many other words and phrases in these results. This is the first time we've had to deal with anything to do with the spine.
It's good to hear his spine has good alignment. We felt pretty lousy the other day when his rheumatologist reviewed his most recent x-rays and said "You have a 75-year old back. Looking at the x-ray you have a bad back." She kept stressing he has a "bad back" which left him feeling more like he was 100 rather than 75. In her defense, she did say she wasn't very knowledgeable when it comes to reading x-ray results (this was before we had the tech's impression.)
You are right that this is all pretty torturous. LOL Though I feel it's important that I learn as much as I can because I'm not thrilled with the treatment he's gotten so far, or lack of treatment in some cases. It feels like most of the doctors, even specialists, are not really on top of their game. His first rheumatologist could literally have cost him his life when she refused to believe he had Giant Cell Arteritis. I had to push for a biopsy which showed he did have it. I knew he did from all the symptoms he had. His was textbook. And it turned out the same rheumatologist didn't even know the proper way to treat him which created huge issues (we finally were able to switch and have a better one now, so we hope). It was an ER doctor who told us he wasn't being treated properly for his condition and put him on high doses of IV infusions (prednisolone). He's been on high-dose prednisone for over a year which is what is causing his bone issues.