Can a bone density test yield different results on different bones?

Absolutely. When I started, my spine was -3.3 and my hips were -1.6 or so,

Yes, it is usual for every bone location to have a different density resulting in a different T score.

Yes, not sure how decision is made to medicate or not. All areas tested for me were osteoporosis (spine, left hip, left femoral neck, so doc medicated). Next dexa is in July; not sure what numbers need to be in order to try a "drug holiday", which for me is the goal. I believe some doctors give a medication break if you get into osteopenia; others treat osteopenia the same as osteoporosis. Is the goal for our bones to be that of the dexa comp of a 30 year old woman? Or just improvement of a certain percentage? I dunno.

Yes, it is called DISCORDANCE.

Search on "discordant dexa results" . One of the articles that search will find is this one (which has a serious typo in it for added confusion):
https://pmc.ncbi.nlm.nih.gov/articles/PMC8671031/

@jozer I wondered this same thing, but someone on Mayo Clinic Connect sent me an article by a well-known expert in osteoporosis demonstrating that getting to a score of -1.5 is just as good at lowering the risk of a fracture as a score of -1.0, the standard score of a 30-year-old woman.

Absolutely. My wrist bones are very strong because I use them and keep them in strong shape. My spine and large bones. Don’t get the same workout and show osteoporosis. Also if you don’t use a DEXA scanner with TBS software you’re not going to get a consistent score between your DEXA scans. On top of that everyone should know that DEXA scores may not be a true reflection of your bone density. But they are the best technology can offer us right now. My scores were pretty good yet when I went in for cervical spine surgery my C5 vertebrae was paper thin and fell apart in the doctors hand. I went through a lot of investigation about the whole thing and I found out that this isn’t a perfect science, and your bones can be different.

@loriesco It is also worth researching REMS test in addition to DEXA.

REMS is newer technology but could prove as good as, or even better than DEXA in the long run.

There are other extensive discussions about REMS on Mayo Clinic Connect that people can search for, so I will not say more here.

Really appreciate you sharing your experience and comment about getting a DEXA that includes TBS score loriesco!

@kfhoz I'll ask. I get a DEXA with TBS the last two years. I don't know that UCSD is offering it to the public. My surgeon probably would say that it wouldn't have helped them prepare for what they found when they opened me up at my neck. There are some things which they just can't tell in advance. But thank you! The lack of radiation seems like a big plus!

@kfhoz which machine would you believe, Rems or Dexa? My dexa was good, Rems no so.

@dvargo I was told that here in the US Dexa is used to determine treatment. There seem to be a lot of people who get very different scores with Dexa and Rems. I'm going to get a Rems scan in February. I'm curious to see what it shows!