Troubling difference between DEXA scan and Echolight

to hungrybirder
I am sure that professional standards in major US hospital are high. It will be interesting to know your November test results.

Same. I had my Rems 1/25. Spine 2.9 and hip 2.5. My quality of bone was excellent so it gave me a 3% of fracture in 5 years. Had my dexa in 3/25, spine 2.5, hip improved to 1.9, no TBS done so my fracture risk in the next 10 years was 10%. Which to believe?

@hungrybirder I too put faith in repeated scans that show consistency or a trend. My 6 DXAS in 5 years or so showed continual decline and then a sudden dramatic increase in bone density. That increase followed a year of Evenity my first and only bone med at that point. I know DXAs are imperfect but for me the results made sense. I've only had one REMS and because I have had only one I do not know what to make of where it's results varied from my DXAs.

For the time being, I'm going with the DXA numbers simply because they have been relatively consistent over the years. I'll know more with the next scan. It's frustrating not. knowing what numbers to trust.

I thought it was time to update the information from my latest DEXA (November 6) which was done at the same hospital since 2014. My spine has gotten a bit worse but still has an L1-L4, T score of -0.8 which when adjusted for TBS is -0.6 versus the REMS scan from July which had a T score of -3.1. I had a great technician and she showed me the results immediately after the scan. She thought her scan might be a bit optimistic given the level of my scoliosis and arthritis both of which have calcium deposits that might be registered as bone. I suspect she is correct to some extent although I doubt it is actually as bad as the REMS shows.
The DEXA values for my hips also TBS adjusted were Left Femur total -2.2 and Right Femur total -1.8. Here again the REMS has me falling apart with a Left T-score of -2.8 and Right of -2.7.
Still don't know which scan is more accurate but the hospital DEXAs seem more consistent over the last 10+ years. Unfortunately my non dominant right arm comes in at a -4.1. Then again I'm small boned and in 2005 my arm came in at -3.5.
I know others have had quirky results and wonder which to believe. I have a February appointment with a new Houston endocrinologist who may or may not be up to date on osteoporosis; getting the first appointment took 13 months. I like my current endocrinologist who is equally small boned but would like a second opinion going forward. My last (the first) Recast infusion was in December '23 so we'll see what the new doc says.
It's all very frustrating.

Where did you get your Echolight scan? Was it at Mayo in Rochester?

A further update, after waiting a year to see the 2nd doctor for another opinion, her office canceled the appointment with no notice. Having learned that complaining to everyone in sight sometimes brings results, the appointment was rescheduled. New doctor, unlike her appointment staff, was lovely and quite knowledgeable although I think this group is great for keeping up to date on treatment options. She had obviously looked at my records and confirmed that all the good spine readings were invalid because of the amount of calcium being read due to many bone spurs. The technician at my last DEXA scan implied the same thing. So she suggested focusing on the hips which she noted have remained stable over the last 5 yrs. Since the current studies show Reclast works longer than originally thought, her advice is to have a 2nd Reclast infusion at around the 3 year anniversary (Dec 2026) and then possibly go to Prolia in another 3 years. She was pretty keen on Prolia as an option and believes there are fewer side effects in 80 year olds. Who knows.
As for my forearm, current drugs don't help there. Bone there is totally different.
And for the difference between the REMS and DEXA she felt there wasn't enough information on how they relate to each other. Maybe, maybe not.
So I plan to have a 2nd Reclast infusion around the 3 year mark and worry about what comes next in another 3 years.