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Profile picture for awfultruth @awfultruth

@janines DXAs are like a great many medical tests - they are both useful and imperfect. And like many medical tests they can have gross errors and require trained technicians to follow proper procedures to get the most accurate results. For most people, most of the time the scans seem to be roughly accurate and consistent and quite useful. I'm fortunate in that that has been the case for myself. I've had 7 scans over the past 6 years and they have all made sense and been consistent. I had consistent and disturbing bone loss year after year until I took Evenity for a year and then I had a huge improvement. My scans were consistent in revealing trends. They made sense.
For you to have fractured despite having a DXA that indicated osteopenia does not at all invalidate your DXA scans. I'm sorry that you fractured. Thinking that your fracture invalidates DXAs actually shows how we are not educated in what DXAs are and how big a part of the risk of fracturing they cover. There are multiple factors involved in how resistant a person is to fracturing, bone density is a huge one and DXAs measure that pretty well (though not perfectly). But there are many factors involved in the quality of the bone besides the density. TBS processing of the DXA scans can give an indication of that for the spine but unfortunately TBS is not widely available, though it would be easy for them to be done with each scan. REMS may turn out to be a valuable tool for measuring bone quality but it's certainly not accepted by most doctors at this point. I would add that at this point in time many people can look back over years of DXAs scans and see that they made sense (or sometimes not). REMS has not been around long enough to have that track record. And who knows if either TBS or REMS or both cover all of the possible important aspects of "bone quality"? I strongly suspect that even with both of those there are other important factors being missed in the bone quality category. And then there's the core muscles supporting the spine that probably play an important role. And then there is your balance and coordination and how often you fall and how well you fall and on and on.
So, the DXA score helps and can be very useful but it is not perfect and it is giving information about one aspect of your likelihood of fracturing. It does not, can not, and isn't designed to, give you information about all the factors involved in fracturing

To get the most useful responses possible for your situation include your actual DXA numbers. The terms osteopenia and osteoporosis cover pretty wide ranges and just are not precise enough.

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Replies to "@janines DXAs are like a great many medical tests - they are both useful and imperfect...."

Thanks so much for your info. That was so helpful!!!