Dexa bone density scans are as good as it gets in the U.S. at present. Europe has begun to switch to Echolight ultrasound technology that measures overall bone quality by combining both bone density measurements and by assessing the microarchitecture of the bone to determine its strength. I have heard of a clinic in NC called Central Carolina Orthopaedic Associates that has an Echolight machine. They advertise scans for $75 plus $100 per review of your medical records. Insurance is not on board for covering these fees yet.
It is frustrating that the U.S. is using mediocre technology, but if you get your scans done at the same clinic each time, there is more reliability. Dr. Brown goes into detail that your osteoporosis scores are not reliable predictors of fracture risk. Many factors play into fracture risk. In my case, when I fractured my knee and wrist, the docs who read the x-rays said, "Lady, you really need to do something about your bones!" They could tell that the microarchitecture of my bones was poor from the way my bones broke. (I also had low impact trauma that caused a great big and cooplex fracture!) There was no healing my knee. I had to have the whole thing replaced. Keep in mind that I do not have Osteoporosis...just Osteopenia. However, my fractures made it clear to me that I had to do something as the Arimidex is doing a number on my bone strength. I look forward to getting yearly Echolight scans when they become available, to get a better idea of my bone quality as I continue to work the Better Bones Program.