Echolight sonogram scan for bones

For years, my DEXA indicated no bone issues. Last year, I got REMS and it showed I had osteoporosis in hips and spine (minus 2.6 hips and and minus 2.8 spine). The DEXA showed no issues. This year, the REMS indicated minus 3.1 spine and minus 2.4 hips. I have no faith in DEXA so does my doc who was sceptical about REMS last year. I think the REMS reading are fool-proof and independent of any extra skills of the technician.

I didn't realize it had FDA approval. Maybe insurance will now cover it. I had one done and had to pay out of pocket. My bone quality was much better than bone density.

@pbradley1954 We also had self-pay REMS scans. FDA approval apparently does seem to mean that insurance companies and doctors will use/accept REMS. Change is risky in the medical profession.

However, my husband's doctor denied him a DEXA scan despite there being reasons to suspect there might be an issue. After she saw his self-pay REMS scan results then she both got him a DEXA and a referral to an endocrinologist.

Below are some tips from the Echolight REMS company about getting reimbursements. I believe that a REMS scan would have to be ordered by a doctor. My own hesitation about trying to get insurance to pay for a REMS scan is that they then might not pay for a DEXA in that 2-year span. And DEXA is still the test that is widely accepted.
https://www.echolightmedical.com/wp-content/uploads/2024/04/Reimbursement-Guide-REMS_USA_Rev01_March_24-1.pdf

I had the dexa and then the rems scan. I prefer the rems scan since there is no radiation and because the machines do not need to be recalibrated like the dexa scans ( which sadly they don't do much) and there is no potential error in the area of the person giving the scan....rems is far more accurate. Also if you do a deep dive you will find that the major share holders of dexa are the SAME pharmaceutical companies that make the meds for osteoporosis. Hmmmmmm now we know there could be no influenece there on these scans making thing look worse I am sure!!!!!! Do you also know when they do the bone scans they are compared to the bones of a 30 year old!!! Really? Who in their 70's has bones like a 30 year old. I am a big believer in strength training, supplements, red onions, and prunes to help bone density and NOT a fan of the meds unless the numbers are through the roof. Make sure if you get a DExa you only get the one with TBS (a fragility score) which is very important. You doctor won't even know what that is unless they really know their stuff. AND there are very few places that offer it but it is covered by insurance and no additional radiation.

@lindamaegirl I liked REMS also, until I saw this post today from @j1976
https://connect.mayoclinic.org/discussion/what-decision-to-make-regarding-osteoporosis/
I found a link to the actual research paper here:
https://link.springer.com/article/10.1007/s00198-026-07960-4.
EXCERPT: "This study demonstrates that REMS-BMD and fragility scores are strongly driven by operator-entered demographics. This suggests the technology functions primarily as a sophisticated, demographically weighted algorithm to predict DXA BMD."

@kfhoz Well that study is disappointing. I just had a rems in SC and my lumbar spine score was -3.0 vs -4.0 on my Dexa. When she weighed me she said 108, I said I weigh 102 without clothes on so with these light clothes and a breakfast, maybe 104. She just responded that this is what the scale showed. Now I wonder if this higher weight is intentional? If you like results, which I did, then maybe you continue to have a REMS Scan. Hmmm.... I so hope this is wrong.

@kfhoz , To add another perspective regarding the reliability of a REMS, 7 years ago, my dexa showed my spine at -2.8. One year later, after a year on Prednisone, the next dexa showed -2.4. My family doctor happily informed me that my spine bmd had actually improved so we didn't have to worry about the prednisone effect. The next follow-up dexa 3 years later showed my spine at -3.5! I couldn't comprehend how my bmd had improved by such a huge amount over one year while on prednisone. When I shared my dexa scans with another Mayo Connect member, she astutely noticed a different serial number on the dexa with the improved score although it was done at the same hospital as the previous one. The dexa with the devastating -3.5 score matched the original serial number from 4 years previous. So my level of confidence in Dexas is not high now. Although the REMS study makes the fragility score questionable, I think that the REMS bmd score is more reliably consistent.

Does anyone know ow where you can get a REMs scan in the Washington DC area?