Difference in scores between DEXA and REMS

I had similar results, with a significantly better REMS lumbar score and about the same DXA femur scores. I could write a book about my confusion, and I can’t say what anyone else should do; however, I do believe that more information is better than less, as long as it is as accurate and research-based as possible. I would suggest looking at Dr. Bush’s website for explanation of the numbers, because most docs are not familiar enough with the REMS to offer solid analysis. Personally, I am not basing any treatment decisions solely on either test, DXA or REMS, but on a combination of health factors unique to me. That’s all any of us can do. If you’d like to know more about my own situation, I am more than happy to chat or message one-on-one.
Here is the link for Dr. Bush’s blog and video resources, although a google search will lead to him and other experts, including Dr. Kimberly Zambito. Another good resource is Debi Robinson’s podcast, Stronger Bones Lifestyle, where she interviews a variety of doctors, including a 3-part session with Dr. Bush.
https://www.boneforte.com/journal

I have had both DEXA and REMS tests. My DEXA results show osteopenia but I broke 5 bones in 18 months. My REMS results were in the Osteoporosis range, which I believe with my fracture history to be more reliable. The DEXA is influenced by arthritis, fractures, poor positioning and does not have a fragility score unless TBS is connected. In addition, DEXA uses radiation, while REMS is just an ultrasound so has no possible negative side effects.

Thanks for the reply and information. I will look at the Drs you mentioned. My realization is that Osteoporosis is poorly understood. the technology used is outdated, and has not been revised. perhaps because it primarily affects women! No one is able to explain what causes the imbalances between Osteoclasts and Osteoblasts, and what would be helpful, useful to create better balance.

Thanks for your reply. Interested that you had the opposite experience with scores. Take care.

I did DEXA in 2023, and REMS is 2024. The REMS showed better spine, and slightly worse hip scores. Will have another DEXA in November of 2025. Might get another REMS then too, so I can compare same time results. The REMS fracture predictions were much lower in both hip and spine.

Glad I found this support group. DEXA in 2023 REMS in 2024 and DEXA last week. Will see my endocrinologist soon at which time I will have to start meds. Guessing he won't trust the REMS?69 yrs, Severe Osteoporosis shown on DEXA spine/hips; getting worse every two years. REMS shows much improvement over DEXA and in Osteopenia range with good fragility score. Then recent DEXA spine worse than REMS, better than prior DEXA; still osteoporosis range. I don't know what to think? I have been working at it with exercise/strength training and calcium/D3. I plan to do another REMS this summer just for the heck of it.

I had both scans recently. The results were odd. My overall spine average was identical in both, but the individual scores (L1, etc.) were wildly different. Somehow it all averaged out the same. The technician did tell me that people tend to do a little better with REMS. I honestly don't know what to think! I'll probably just stick to DEXA next year. REMS is so new, the doctors don't know anything about it.

I found it disconcerting that the " specialist"... Endocrinologist did not know anything about REMS and showed no interest.. I find myself a bit bewildered at how to focus on the health of my bones and what is needed.. and not pulled into fears and worst case scenario.. All of the results are based on statistics.. which are not well understood and explained.

Thank you for the information given. I appreciate that Dr. Bushes website. I wish I had this resource in my area. I learned about the REMS thru this osteoporosis support group. I live on the west coast so am having to travel to Canada to get a REMS. Will have to try and interpret the results myself since no one in my state gives or knows how to read this test. But I do like the fact that I can get one of these REMS in Canada and monitor my osteoporosis without having to wait 2 years to get an updated DEXA scan. Currently waiting to get an appointment with an endocrinologist. Wait times in Oregon can be 3-6 month. I appreciate your commitment to advocating for your health. It’s what I have learned over time. Keep asking questions, keep seeking that Dr. who will work with you. I want information and 1 year to figure out whether to take the Fosomax I was automatically prescribed by my PCP or if I can make positive changes in spine scores through vitamins, impact training and diet.

Hi, I'm in Oregon just south of Portland. I went to Osteostrong in Bend to get a REMS. You don't have to be a member, just call to schedule. And they're bringing the Bend REMS machine to the Happy Valley Osteostrong location in March for scans (they're scheduling right now, just got the email). I don't know where you are in Oregon but it's possible other Osteostrong locations might have a REMS machine.

I've now had two DEXA scans two months apart (because the first one was so unexpected) and both showed bad osteoporosis numbers in the -2.8 hips to -3.8 spine. But my REMS (done two weeks after the first DEXA) showed only osteopenia in hips and just the beginning of osteoporosis (-2.6) in the spine and good "quality" for all measures. It's very confusing why the REMS is so much better.

I'm in the same situation waiting for the referral to endocrinologists at OHSU to get response (been months now). Good luck.