Who has had a discordance on their DEXA with the T scores.

Same machine/facility?

@njx58 yes

@kristie2 That's a pretty big difference. How long between the two scans? Were you on any medications or doing anything for your bones?

The machine operators do make mistakes.

kristie, did your total hip (TH) T-score improve to 1.0? LS -3 vs TH 1 would be major discordance. Do you have TBS numbers?

I had minor discordance at the time of diagnosis. From what I’ve read, differences between spine and hip scores are common - seen in roughly 40–50% of postmenopausal women. Early after menopause, the trabecular bone of the spine has higher turnover and can lose density faster than the hip, so the spine score is often the lower of the two. With aging, degenerative changes in the spine (osteophytes, endplate sclerosis, and sometimes aortic calcification) can falsely elevate the spine reading, making it appear better than it really is - and better than the hip. This effect increases with age - present in roughly 1/3 to 1/2 of 70-year-olds, and affects the majority of the lower spine by the 80s.

Unfortunately it doesn’t show that on my DEXA report.
I was watching a podcast with Dr. Doug Lucas talking to Dr. Tony Keavery
on YouTube. He is a bone scientist. It was very interesting what he had to
say about this. He says that the Spine DEXA is unreliable. Many conditions
can be skew the score such as degenerative changes.
On Wed, Sep 30, 2026 at 11:56 AM Mayo Clinic Connect < nf+07394b08+147318142@n1.hubapplication.com> wrote:

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> *Comment* posted by @mayblin
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> on discussion "Who has had a discordance on their DEXA with the T scores. ".
>
> kristie, did your total hip (TH) T-score improve to 1.0? LS -3 vs TH 1
> would be major discordance. Do you have TBS numbers?
>
> I had minor discordance at the time of diagnosis. From what I’ve read,
> differences between spine and hip scores are common - seen in roughly
> 40–50% of postmenopausal women. Early after menopause, the trabecular bone
> of the spine has higher turnover and can lose density faster than the hip,
> so the spine score is often the lower of the two. With aging, degenerative
> changes in the spine (osteophytes, endplate sclerosis, and sometimes aortic
> calcification) can falsely elevate the spine reading, making it appear
> better than it really is - and better than the hip. This effect increases
> with age - present in roughly 1/3 to 1/2 of 70-year-olds, and affects the
> majority of the lower spine by the 80s.
> VIEW & REPLY
>
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@njx58 yes I have been on bone meds. I have always had the same numbers on my hip. I have been getting DEXA’s every year when my T spine was -4.6. Same machine during this time.
I am just interested in anyone who has had discordance with their numbers and what their docs have said about this.

I questioned my Dexa scores from earlier this year and followed up with a REMS which was even more confusing. My spine showed osteoporosis on the Dexa at -3.6 but was -2.7 on the REMS. My hips on Dexa were only -2.0 but -3.0 on the REMS. For the Dexa test, I learned later that I shouldn't have exercised before the test and something else....maybe drink caffeine, though I can't remember the other thing.....both of which I had done. This is said to skew the Dexa. For the REMS, I prepared better. The thing that was curious to me was that on Dexa my spine showed a 12% loss in two years. I was on no meds only good exercise, protein intake and good nutrition...no collagen yet. However, my spine is straight, no pain and no loss in height at all. So I question that is was really that bad. However, I took the knowledge that I still needed to do more than I was. Stopped diet coke, drank more water and was able to start Forteo. I have since added HRT ( I had taken oral HRT 20 some years ago but stopped because it effected my liver enzymes). So even though I'm 74 now, I restarted HRT with estrogen patch (or gel if that becomes unavailable). I wouldn't ever have stopped if I knew the patch wouldn't effect my liver. More info than you asked for but I also listened to the video mentioned with Dr. Doug and Dr. Tony....on YouTube. Dr. Tony said the spine results on Dexa could be off.

@kristie2 PS my primary docs are not helpful with this at all. My endo was quite helpful. He had actually had a spine fracture and was greatly helped from the Forteo.