Reliability of DEXA scans
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Posted 15/01/2010 09:48:14 Post #1142
 

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Just over three years ago I had my first DEXA scan which showed osteoporosis in both my spine and hips, however the density in my spine appeared better than that in my hips. Soon after this I had a CT angiogram of my heart and the radiologist noted in his report that I have "mild degenerative changes in the spine". I don't ever have any back problems, no pain or stiffness, nothing, so this comment didn't bother me.....until now:

Following on from a post by another forum member with osteoporosis who found that she had "a large increase in bone density way over the normal" on DEXA after having been diagnosed with degenerative changes in her spine I've been doing a lot of research. On the NOS website, the NHS Choices website, courses.washington and others, it says that if there are degenerative changes in the spine then this gives an inaccurate DEXA scan result making the bones look denser than they really are !

This would explain why my bone density on DEXA looks better in my spine than in my hips. But it's a false reading and so my spine's density is actually lower than it appears.....but what is it ? How can I ever know the true density ?

For how many others does this happen ? If I have no symptoms of "degenerative changes" then I'm sure others are like me too. I used to work in an x-ray department typing up x-ray reports and I can't tell you the number of times that a report on an age 50+ person noted degenerative changes, noted by chance like with my heart CT angiogram, not when the patient had been complaining of pain in the spine but simply when they'd had a chest x-ray for something.

I shall be asking my consultant about the reliability of DEXA scans next time I see him and suggest that instead he does blood tests for markers of bone turnover since I don't think my DEXA scan can ever be reliable in telling my bone density !

Anne


Osteoporosis - Strontium Ranelate, Dekristol vitamin D3 20,000 IU/week, weight lifting, walking and vibration platform exercise, alkaline loaded diet, vitamin K2 MK-7 200mcg/day. Diabetes - Repaglinide, low carb diet and exercise. Congenital heart defect - Omacor and CoQ10. Small airways disease/asthma - Qvar 100. Probable coeliac.
Posted 17/01/2010 21:25:05 Post #1147
 

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Hi Anne

Thanks for a very interesting post.  I, like you, have been on Protelos for about 3 years and my spine DEXA was -3.8 then.  I had a further DEXA last year and it was -3.5 but they didn't take into account the artifactual effect of strontium, so don't think there is much of an improvement.  I too have degenerative changes in my spine, so dread to think what the real T.score is!

I await with interest your findings.

Jess

Posted 24/09/2010 03:12:21 Post #2665
 

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Hi, I am a Registered Dexa Technologist and Radiology Technologist....I have learned through experience and much in deapth reading that some disease processes will elevated your BMD for some, or all, of you vertebrae....for this reason, the vertebrae with elevated results (hot Spots) should be eliminated from the over all average BMD for the L Spine.  BUt, the analysis should be based on at least 2 normal vertebrae for accurate results.  You want your results to measure what is representative of the rest of your body not your disease process.  If there are not two normal vertebrae available, and alternate site should be measured (non-dominant forearm for example).  Discuss this with your technologist....if they do not know what you are talking about, select another facility that does.
Posted 24/09/2010 08:39:30 Post #2666
 

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Hi bonelady - What is the formula you use for adjusting the bone density results when a patient is prescribed Protelos (Strontium Ranelate) please ?

Osteoporosis - Strontium Ranelate, Dekristol vitamin D3 20,000 IU/week, weight lifting, walking and vibration platform exercise, alkaline loaded diet, vitamin K2 MK-7 200mcg/day. Diabetes - Repaglinide, low carb diet and exercise. Congenital heart defect - Omacor and CoQ10. Small airways disease/asthma - Qvar 100. Probable coeliac.
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