Has anyone had a rems bone scan or tbs bone scan?

Unfortunately, I live in Wisconsin, so not an option for me. Otherwise I would go in a heartbeat!

Medicare covers the cost of a bone density scan for you every year for the last 20 years? I've been diagnosed with osteopenia for over 20 years and have only been able to get one approved every other year, even as my condition has worsened

I’ve had different insurances and only have had Medicare for 4 years @harrington50. I did hear some thing about every other year for Medicare however, I think my doctor just had to write for a prior authorization to get it approved. It is possible that I have diagnosis which makes it easier to have it done every year with all the arthritis and degenerative conditions I have. I hope you are taking bone medication’s. There are other numbers when you take the bone medication’s that will help you improve your scores.

@harrington50 @loriesco
I believe much has to do with how much effort your physician will put into it. Some will just stick with the customary two year protocol and look no further if there are exceptions. If the physician states you are already being treated for Osteoporosis, an annual DXA can be ordered. I have a rheumatologist that won’t even try. I just went out and paid for a REMS out of pocket for my own peace of mind. Same rheumatologist has no interest in looking at the REMS result. One must really advocate. It’s exhausting but usually worth it.

I'd be happy to pay for REMS, but there aren't any providers near me. I'd love to have some baseline scans and testing done, but since I'm not buying what they are selling, I, too am exhausted from attempts to get any medical doctor's support beyond their standard protocols

@harrington50 I was curious how you have gotten worse and are you in a treatment program? It seems to me all these tests are a nice luxury but according to my surgeon, they are only generalizations. My orthosurgeon just looks at the xrays he does in his office and see can see the real condition of my bones. (not good, LOL) so maybe don't stress too much. If the doctors don't give you the attention you are looking for -- maybe it means you are in good condition even if the numbers aren't what you'd like to see.

The purpose of baseline scans and testing is to establish a baseline before beginning therapies so later those scans/tests can be repeated to determine if therapies are working. Unfortunately, many doctors won't make the effort to try to get Medicare/ insurance approval for testing that is out of the range normally prescribed, even if the diagnosis is severe, especially in over 65 patients.

A doctor cannot determine your bone density from a X-ray. If that were true, why would we even use DEXA? When I had a compression fracture, my orthopedist said "looks good, it's healing nicely", and in the meantime I actually had osteoporosis.

Your doctor informing you your fracture is healing nicely "may not" have anything to do with you having osteoporosis as far as the doctor knows. You haven't provided enough information. However, my orthopedic surgeon LOOKS at the xrays and can SEE the bone demineralization which tells us all that I need to be on bone meds. Why didn't he tell me that years ago? Maybe he made presumptions that the other doctors were dealing with it - afterall, he is just a surgeon! 😉 And maybe now that he went in to find soft bones like paper he is more attentive. I don't have osteoporosis. Like I said - The DEXAs are a general thing. Because I have had all my large joints replaced they have to use smaller ones like my wrists. And my wrists happen to be VERY strong because I lean on them tons for work. So the DEXA with the TBS is the way to go. And now that I am on bone meds the CTX and P1NP over time, plus the dEXA plus the xrays tell everyone about my body. You might want to read how Bone Density measurements are fracture risks are not linear: https://www.aafp.org/pubs/afp/issues/2010/1001/p752.html
And actually - you can see the demineralization when comparing my x-rays to each other. My surgeon showed me. They have high-quality equipment at UCSD and knowledgeable
orthopedic surgeons. https://pmc.ncbi.nlm.nih.gov/articles/PMC3244670/#:~:text=Significant%20bone%20loss%2C%20as%20much,osteoporosis%20on%20radiographs%20of%20adults.

I understand the purpose of a baseline. However in the case of some tests they are not good indicators because they more or less measure, as an example, what is in your bloodstream and not in your cells, OR the conditions need to be EXACTLY timed between the first baseline and subsequent tests, OR the equipment is not calibrated EXACTLY to the equipment you had the original test on OR the radiologist doing the "read" interprets differently than the first OR you ate something the night before one of the tests that shows up in one test and not the other. There are many reasons that tests don't work as good baselines OR a stable predictive measurement between a first and subsequent test. Sometimes, it takes repeats over time and controlling conditions to really come up with accurate accounting. There is a lot of faulty and unreliable tests so the doctors don't want patients to worry. The proof will be tested over time with a trend line. They can't measure every available bone in my body to get an accurate assessment. When people get compression fractures, THAT is how they are diagnosed. Not before a fracture.