Dexascan Reporting

Posted by joegor @joegor, Jun 1 11:40am

While reading the report on my latest dexascan I came across the following:
"Complete measurement data at multiple sites are available in summary images in PACS"
I contacted my doctor's office and asked if this data was available to me and they sent me photocopies of more detailed measurements from my last 3 studies. A couple interesting things came to light. Turns out the numbers we get in a typical report are a summary of the total. The T-score reported for my lumbar spine was the average of the individual scores for L1 thru L4. Although my number was reported as -2.9, 3 of the 4 individual scores were actually better than this. The final number was skewed by one measurement of -3.6. On the other hand the T-score for my left hip was reported as -2.7. This was at the neck and was actually the lowest of 3 sites measured, while two other sites described as troch and inner both measured -1.5. I know like a bridge we're only as strong as the weakest spot, but I found it interesting that they report an average for the spine but worst number for the hip.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

dtevis | @dtevis | Jun 2 8:37am

That "weakest part of the bridge" that you mention is the area of my hip that I have been most interested in checking when I get my DEXA because of the following information from American Academy of Orthopedic Surgeons (AAOS). The vast majority of osteoporotic hip fractures occur in the upper part of the thighbone (femur) where it meets the pelvis. Femoral Neck Fractures: These occur just below the ball (femoral head) of the hip joint. They are extremely common in older adults and are a primary concern because they can disrupt the blood supply to the bone.

sandy0257 | @sandy0257 | Jun 3 5:37am

Wow! @joegor and @dtevis…
That’s so important to know!!! It’s like conducting brain IQ testing on children and only looking at the total score of IQ without revealing and studying the strengths/weaknesses of the sub-tests regions of the brain.

Going back to DEXA scans…not giving us exact scores at every section, does not help us make accurate decisions and gives false misleading, inaccurate testing results.

sandy0257 | @sandy0257 | Jun 3 5:42am

Wow! That’s so important to know!!!
It’s like conducting a IQ brain test on children and only looking at the total IQ score without revealing and studying the strengths/weaknesses of all the sub-tests regions of the brain.

Going back to DEXA scans…not giving us exact scores at every section, does not help us make accurate decisions and gives false misleading, inaccurate testing results.

lindamaegirl | @lindamaegirl | Jun 3 6:56pm

I find that the REMS test is far more accurate and the idea of a fragility score makes it even better

joegor | @joegor | Jun 3 8:30pm

In reply to @lindamaegirl "I find that the REMS test is far more accurate and the idea of a fragility..." + (show)

@lindamaegirl I'm not familiar with this test. Is it generally covered by insurance/Medicare?

dvargo | @dvargo | Jun 4 6:01am

In reply to @joegor "@lindamaegirl I'm not familiar with this test. Is it generally covered by insurance/Medicare?" + (show)

@joegor No. $250 out of pocket.

babybear77 | @babybear77 | Jun 4 7:53am

What is a REMS test?

donnabutcher | @donnabutcher | Jun 4 8:40am

In reply to @lindamaegirl "I find that the REMS test is far more accurate and the idea of a fragility..." + (show)

@lindamaegirl
Why do you think a REMS test is better? From my reading, the REMs score is often reassuringly better than DEXA but isn’t accurate. Many gyms, temporary screening events, places like Osteostrong set up portable machines and don’t have trained experienced techs doing them.
Arthritis snd strontium can artificially inflates DEXA
Quantitative CT is more accurate but uses more radiation and may not be covered by insurance.
However in my case and my husbands the QCT showed much lower density than the DExa .
His April DEXA showed osteopenia, by July he had fragility fractures , did QCT which showed severe osteoporosis. Those results made him eligible for Evenity.
I am 82 and all my DEXAs over the years showed normal results including the one a few months prior to my QCT which showed osteopenia almost to osteoporosis in one area. That alerted me to take action to prevent it from becoming worse.

kfhoz | @kfhoz | Jun 4 10:38am

In reply to @donnabutcher "@lindamaegirl Why do you think a REMS test is better? From my reading, the REMs score..." + (show)

@donnabutcher I agree! Two new research papers have shown that REMS is primarily "guessing" rather than "measuring" your bone density based on your demographics such as your age & height & weight.

I have had REMS and have posted elsewhere on this site my experience and links directly to the two research papers. Here is a terrific overview from Margaret Martin at MelioGuide. You can look up the studies based on her descriptions of them.
https://melioguide.com/osteoporosis-prevention/rems-bone-scan/
Previously I have posted suggesting people try REMS and I had been planning on using REMS as a close monitor of my BMD. I am very sad about the outcomes of the recent studies.