@dvargo I think most doctors will treat based on Dexa. Did you get a TBS score when they did your Dexa? That should tell you bone quality. That can be important in determining if you need treatment or not. If not then I would seek that out. Your REMS scan can evaluate bone quality so if your bone quality is compromised you can get a poor score. If Dexa only measured your bone density without TBS it's possible it gave you a misleading "good" result. You can have good bone density and poor bone quality.