Do petite women get over-diagnosed with osteoporosis?

@gigi4
Hi, l scheduled a REMS for myself for this week. It is $450, no insurance coverage. I wasn’t sure it was worth it because it’s through osetostrong which l am highly suspicious of. Did your endocrinologist suggest it? I am looking for a new endocrinologist. Are you in the tristate area?

@gigi4
Hi, l scheduled a REMS for myself for this week. It is $450, no insurance coverage. I wasn’t sure it was worth it because it’s through osetostrong which l am highly suspicious of. Did your endocrinologist suggest it? I am looking for a new endocrinologist. Are you in the tristate area?

@gigi4
Hi, l scheduled a REMS for myself for this week. It is $450, no insurance coverage. I wasn’t sure it was worth it because it’s through osetostrong which l am highly suspicious of. Did your endocrinologist suggest it? I am looking for a new endocrinologist. Are you in the tristate area?

@amyt123 I also had REMS scans, and I have posted in the past suggesting REMS to people on this site. But I no longer trust REMS results based on 2 new research papers and my own results. I am trying to now balance out for my former advocating of REMS. Below is an overview from MelioGuide that also indicates where to look to see the original research which I have also read.
https://melioguide.com/osteoporosis-prevention/rems-bone-scan/
EXCERPT 1: "A 2026 study in Osteoporosis International (Chan et al.) found that age and weight alone explain the vast majority of REMS output variance."

EXCERPT 2: "The Bobelyak et al. Study (2025)
An earlier study by Bobelyak and colleagues found similar concerns. Their model using only age, sex, and BMI accounted for approximately 90% of the variability in femoral neck REMS-BMD. Perhaps most provocatively, they reported that REMS showed only minimal change in hip BMD values after a patient had a metallic hip prosthesis inserted, a scenario in which any device truly measuring bone should show a dramatic change."

The second excerpt describes my situation. The local DEXA scan people would not do both of my hips, despite the fact that I have more heavily used one leg over the other for 12+ years due to knee arthritis in my other leg. I was very surprised when REMS reported my hips to be the same T-score! Other studies show that when one limb is stressed more than the other then that leg or arm develops more bone density. But the research above explains that REMS is 90% estimating your values based on things like age & weight, not the actual bone density difference in my hips.

I was planning on relying on REMS, which only cost me about US$170 in Vancouver Canada, to monitor my bones more often than DEXA. So I am very sorry to see this sad outcome.

My doctor recommended a REMS bone test. It looks at density and quality of bone. Also gives you your fracture risk. It’s relatively new so there may not be one in your area yet, but definitely worth checking out!

@amyt123 I also had REMS scans, and I have posted in the past suggesting REMS to people on this site. But I no longer trust REMS results based on 2 new research papers and my own results. I am trying to now balance out for my former advocating of REMS. Below is an overview from MelioGuide that also indicates where to look to see the original research which I have also read.
https://melioguide.com/osteoporosis-prevention/rems-bone-scan/
EXCERPT 1: "A 2026 study in Osteoporosis International (Chan et al.) found that age and weight alone explain the vast majority of REMS output variance."

EXCERPT 2: "The Bobelyak et al. Study (2025)
An earlier study by Bobelyak and colleagues found similar concerns. Their model using only age, sex, and BMI accounted for approximately 90% of the variability in femoral neck REMS-BMD. Perhaps most provocatively, they reported that REMS showed only minimal change in hip BMD values after a patient had a metallic hip prosthesis inserted, a scenario in which any device truly measuring bone should show a dramatic change."

The second excerpt describes my situation. The local DEXA scan people would not do both of my hips, despite the fact that I have more heavily used one leg over the other for 12+ years due to knee arthritis in my other leg. I was very surprised when REMS reported my hips to be the same T-score! Other studies show that when one limb is stressed more than the other then that leg or arm develops more bone density. But the research above explains that REMS is 90% estimating your values based on things like age & weight, not the actual bone density difference in my hips.

I was planning on relying on REMS, which only cost me about US$170 in Vancouver Canada, to monitor my bones more often than DEXA. So I am very sorry to see this sad outcome.

laren3, W
the discrepancy in inherent in the 2-dimensional dexa measurement. With a dexa score, the actual bmd would be higher in a small bone than it would be in a large bone because dexa doesn't register volume of the bone.
The numbers generated through dexa and QCT can't be directly compared.
Because I have an older spine, the concern was that dexa might be giving me a better T score by including bone spurs. With a lower score, I might have chosen a different medication (Tymlos instead of Forteo).
QCT measures trabecular bone the more delicate inner portion of the vertebrae and femoral neck. Dexa measures both cortical and trabecular bone

@gigi4 Just so you know there is also a DEXA scan with TBS Why doctors don'tsuggest this...the TBS is the fragility score!!!! There is no more radiation but needs to be done on a newer machine. I guess they want to pay for all the older machines!!! (so they do not suggest the newer machines)...NOTE: I live in Boston Ma. You would think with all these great hospitals and universities here there would be several of these newer machines. NOPE.
there is ONE at the Brigham on longwood ave and the WL is about 6 months...I guess there are a few people in the know. I talked my endocranologist in getting me to do this dexa after 6 months of my last dexa and my 2 compression fractures because I want to start and stay on this new machine for all my dexa scans.

@kfhoz Rems in Massachusetts only does one hip. NOTE: take a look at who the major shareholders of Dexa scare are.....surprise surprise the pharmaceutical companies that sell some of the drugs for osteoporosis!!!!