DEXA SCAN RESULTS. Help needed to understand t... - Bone Health

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DEXA SCAN RESULTS. Help needed to understand them please.

Pinklady45 profile image

Belatedly after many requests my Doctor gave me my Dexa scan report.

It is now almost two years so I realise the situation may have got worse, however I would be grateful for any input from the Forum to help me understand these figures especially the Z scores.

I am currently on Risedronate having done Alendronic Acid for 20 months with bad side effects as mentioned in an earlier post.

Thank you.💗

43 Replies

I'm guessing you've had a fragility fracture, as those scores alone don't indicate osteoporosis. Your t-scores show that you have osteopenia, which probably nearly all post-menopausal women would have if tested. Osteopenia is a t-score between -1.0 and -2.5 (so your hip score isn't even quite in the osteopenia range); osteoporosis is a t-score of -2.5 or lower (eg -2.7, -3.0 etc). Your z-scores show that your bone density is excellent (denser than average) for your age. It's very common to fracture with osteopenia, as bone density isn't a very accurate indicator of bone strength, so if you have had a fragility fracture (one that happens with little or no impact, eg falling from standing height), that would mean that, despite the good bone density scores, your bones aren't as strong as they should be, hence the need for medication. But if you haven't fractured, I would seriously question why you're on meds at all.

Pinklady45 profile image
Pinklady45 in reply to Met00

Hi Met00,

Many thanks for your most helpful response.

I had stress fractures in my feet, three Metatarsals in the right foot and one in the left.

These were very belatedly diagnosed when I insisted on x rays as my Doctor said the pain I was experiencing was either Arthritis or Bursitis!

I could hardly walk for the pain and ended up on Codeine.

At a Wedding a very large lady had stepped back on to my right foot , she was wearing very high thin heels and I think that was the start of it all! I was in agony for the rest of that day and was never right again.

My Doctor said, two years ago now after the x rays and the Dexa, that I was at high risk of a fractured hip and she had prescribed AA and to pick them up on the way out. It was very much a case of thank you and goodbye, next please.

As you can imagine I was somewhat in a state of shock, I know I am 75 but have always eaten well and walked a great deal. I am not overweight and considered myself in good shape until then.

With Covid and Lockdown and my Husband being a Shielder , I guess until recently I just accepted this as my lot in life so to speak.

Then I found this Forum and it opened my eyes to so much!!!!!!

I had started to question if indeed medication was needed at all.

So thank you so much for your input, now I am on Risedronate which gives me very few problems I think I might stay on it until I have done my three years which NICE say is the optimum time. This will be in September 2022 when I shall ask for another Dexa ( paying if refused) and come off of this medication unless my results are very bad when I shall have to rethink possibly.

Take care and stay safe, continue giving such good advice to us all.

💗 Pinklady 45

MaggieSylvie profile image
MaggieSylvie in reply to Met00

I didn't know this section of HU existed! I joined another forum for people with osteoporosis but I now know I haven't got osteoporosis, and the forum isn't helpful unless you just want to say hello and give hugs to people outside the UK!

Met00 profile image
Met00 in reply to MaggieSylvie

Were you diagnosed with osteoporosis and, if so, on what basis? I almost certainly didn't have osteoporosis when first diagnosed (error in spine score, hip score was osteopenia at the time), but the diagnosis gave me the incentive to start exercising and eat more healthily, so on balance I've definitely benefited! I'm having my second REMS scan (see explanation in my post below) in just over a week's time, and will then have a better idea of my bone strength (that score wasn't available with the first scan), which is much more relevant than bone density!

MaggieSylvie profile image
MaggieSylvie in reply to Met00

I have NOT been diagnosed with osteoporosis and no-one has suggested I have osteopoenia either. I hadn't heard of an REMS scan before but knowing more about my bones probably wouldn't make a difference. I'm 76 and had a fall about three or four years ago that presumably would have caused the initial trauma for causing spinal compression fractures. Perhaps my bones have never been strong, and if I wasn't already having various tests for other matters, I might ask for it. My GP certainly isn't going to suggest it!

If I had those scores I would be very happy and would have been shocked if offered an OP drug. There must be some other reason why you have been taking AA and then Risedronate. I cannot understand why it was so difficult to obtain a copy of your results.

I have just read that in one of your replies to another forum member you mentioned stress fractures in your feet. Is this the reason why you are taking an OP drug?

Pinklady45 profile image
Pinklady45 in reply to Kaarina

H Kaarina,

Many thanks for responding to my post, I guess I allowed myself to be fobbed off by the Doctor, that is the truth of it. In the end a very helpful Receptionist printed it all for me, bless her.

I have always avoided Doctors like the Plague itself and hardly went once a year, if that, until the problem with my feet (see above reply to Met00).

When the Doctor said I was Osteoporotic I never questioned it you see, just accepted it as what happens when you get old. My Mother was very badly affected by this towards the end of her life when no treatment was available and I was just thankful there was something I could take to help.

Now I have found this Forum with all the lovely helpful people on it I feel so much more emboldened.

I do wonder if Doctors get paid extra for putting us on this treatment, my Husband is convinced that is the case and that I was just a tick in her box!

Take care and thank you.

💗Pinklady45

Kaarina profile image
Kaarina in reply to Pinklady45

I am not sure about the financial side when doctors put us on OP drugs for example but I do know that AA and then Risedrone is offered if the AA does not agree with you. They are the cheapest options out of the OP meds and that is the order in which the doctors are told to prescribe if thought that a medication would be advantageous.

I was automatically written a script for VIT D and Calcium tab lets as most of us are. I was not happy taking them, went back and discussed the situation with my doctor. He agreed that I took enough calcium in my daily diet and since then has only prescribed Vit D tablets. Why do we have to research and then go back? Surely the doctor could ask before prescribing this med.

This is a lovely forum and I have learned much from it. :)

Ritcey profile image
Ritcey in reply to Kaarina

Hi, you will need Vit K2 to assist Vit D and getting calcium into the bones

Book
Pinklady45 profile image
Pinklady45 in reply to Ritcey

Thanks for the info Ritcey, am taking a multi vitamin and mineral supplement already and have been for decades now but will check the small print to see if this is included!💗Pinklady45

Met00 profile image
Met00 in reply to Pinklady45

Even if K2 is included, it's likely to be a very low dose if it's in a multi-vitamin and mineral supplement, and is also more likely to be K1 rather than K2. It's recommended to take 90-180mcg K2-MK7.

Pinklady45 profile image
Pinklady45 in reply to Met00

Thanks yet again for good info.💗

MaggieSylvie profile image
MaggieSylvie in reply to Kaarina

I have similar scores and happy with them. That didn't stop the four compression fractures that happened when I slipped in the garden. I guess I fell heavily, but only one of them showed up at the time. Painful. The others showed up after bending/lifting activities - screamingly painful. I take AA - and care.

Kaarina profile image
Kaarina in reply to MaggieSylvie

Sorry to hear that. My scores are not as good as the ones mentioned. I trip and fall but so far have not broken anything. 🙏

Ive just read your message to Met00. Is this the same doctor that took her time to give you a copy of your dexa scan? The same doctor when you had to insist on xrays on your foot? The same doctor who told you to pick up your script of AA on the way out? If so what an uncaring doctor and I feel very sad to read the way you have been treated.

Pinklady45 profile image
Pinklady45 in reply to Kaarina

Yes same Lady Doctor, we think a Lady Doctor cares more for us but I think that is not the case now!💗

Kaarina profile image
Kaarina in reply to Pinklady45

Oh my goodness, you poor love. I would never wish to ever see her again. How dare she treat you the way she has.

Pinklady45 profile image
Pinklady45 in reply to Kaarina

In fact I had to wait three weeks for a telephone consultation with her to get my prescription changed to Risedronate, when she kept quoting this Dexa report to me. Now I have a full copy thanks to the Receptionist I can see the Doctor was rather overegging it!

About two weeks after this and after the Receptionist had helped me out the Doctor then sent me a very much abridged version with just the scores. Very telling I thought! Take care.

💗

Abridged? You mean she didn't send you a copy of the result? In other words, she edited it! Not good enough.

MsHoliday profile image
MsHoliday in reply to Pinklady45

Pinklady45 What you have gone through shows how much we need to be our own advocates!! I would now get other 2nd or more opinions having had experiences that are very questionable! Thankful for this forum!

MaggieSylvie profile image
MaggieSylvie in reply to Kaarina

My DEXA scan report was sent from the hospital directly to me.

+Z scores mean your bones are STRONGER than those of your peers. bone

(unless that's after taking a bone med, in which case, maybe they are and maybe they are not -- bone meds add bone but not very well or in a strong fashion, but are study proven to halve your fracture risk on average, except for boniva which has no proven fracture reduction effect on hips/femurs)

~wbic

Pinklady45 profile image
Pinklady45 in reply to wbiC

Thank you wbiC , your input is very welcome, it confirms along with others comments, what I had in my heart of hearts thought, that I was fit and healthy and in lots of cases in a much better state than my friends of a similar age! The DEXA scan was done before I had taken any medication!💗Pinklady45

Met00 profile image
Met00 in reply to Pinklady45

What you do need to take account of though, is that you had those stress fractures in your feet. Unfortunately bone density isn't an accurate measure of bone strength. Apparently more people have fragility fractures with osteopenia than do with osteoporosis! If you're able to afford it and there's a clinic near you, you might be interested in a REMS scan, which uses ultrasound to measure bone density with an additional measure of bone strength. There's information here: osteoscanuk.com/.

Pinklady45 profile image
Pinklady45 in reply to Met00

Thanks for that info Met00,💗

Z and T refer to age-groups. Being over 70, I am in the T group. What I mean to say is the T score compares you with others of similar age and the Z score compares you with those in their thirties.

Met00 profile image
Met00 in reply to MaggieSylvie

You're right about the difference, but it's the other way round. T-scores compare your bone density with that of an average 30 year old, at the age of peak bone mass, to show how much bone density has been lost since then. Z-scores compare with average for your age.

Thanks for putting me right! Sorry if I mislead anyone. Put it down to lack of oxygen in the blood!

I wouldnt take bisphosphanates with osteoporosis let alone with osteopenia. They can do as much damage taking them as not taking them. Check out Qfracture.org for for a better view if the possibility of a osteoporotic incident in the future. Its better than frax xx

Mmm what I thought. Was very dubious when prescribed them for osteopenia . Didn’t take them. Now I’m osteoporosis and been prescribed risonedrate but not taken those yet either. Had 2 fractures first at age 59 neck of femur and now age 61 distal femur bad fracture needing ORIF surgery.

Have you ever had your calcium checked?

Not that I am aware, this is my next quest!!!!💗Pinklady45

Nobody has ever mentioned having my calcium checked. Can I get this done independently at a pharmacy, for example?What would the results of that test show? Many thanks.

It has to be done by GP. I have osteoporosis. It has been caused by having high calcium in my blood which in turn has been caused by a faulty PARAthyroid gland which causes the bones to constantly release calcium in to the blood. I have just had the faulty ( 1 of 4 ) gland surgically removed and my surgeon assures me my osteoporosis will reverse within 2 years. Not all osteoporosis is caused by this but it needs to be ruled out......x

Thank you for that information. I shall see if I can get that test done. I’m not sure but I think eventually if the calcium in the blood got to high that can cause/contribute to atherosclerosis? I might be wrong though.

Glad you’ve got sorted and hopefully your osteoporosis will reverse in due course.

Yes calcium released from where it should be can cause osteoporosis but then it gets dumped where it ought not to be, kidneys ( creating stones ) and arteries leading to potential life threatening scenarios and the levels dont need to be very high to create havoc

Thanks for that link Cappuccinobaby will follow that up.💗Pinklady45

You are welcome but please get hyperparathyroidism rulef out x

Will do!💗

Hello Pinklady45,

You.have certainly had to wait overly long for your results ( but often we do not get them sent to us unless we pester)

Why should it be that way?

I asked for my last 3 reports to be posted out to me but still had to make endless phone calls all 3 times before I received them.

I think other members have made a good job of explaining about your scores.

If you have not seen these I have attached an image of a chart of my dexas from a few years ago. (2018)

The grey area shows above average bone density and the black shows below average.

You can see my results started at the bottom of the black( osteopenia) and have headed downwards ever since.

Your own results would be somewhere in the middle of the black region.( representing your T scores)

Hope this helps you .

Bone density of hip.

Thanks for that info Sunseaandsand, all information is very gratefully received.

Such a shame that I got more help from the receptionist who printed me out all three pages of a very detailed report which not only gave scores but laid out what I should be doing to help myself apart from medication. Diet recommendations and also for exercise, simple things also like climb more stairs! None of which information was originally passed to me by my Doctor. When I finally got an email from the Doctor it only gave me the bare scores with no explanations!

It was only the prompting of one of the helpful people on this Forum telling me I had a right to see my report that spurred me on for which I will always be grateful. Take care and stay safe on your own journey.

💗Pinklady45

If my original t-scores had been that good I would never have been offered medication (which btw I refused anyway). Your foot problems are so obviously NOT fragility fractures but the result of an improperly treated serious injury. Your risk factor is age, which comes to us all, and also medications can cause bone thinning so that is another possible issue. But t-score and fragility fracture should not, from the info you've given us, be included in your FRAX (likelihood of fracture).

Pinklady45 profile image
Pinklady45 in reply to HeronNS

Thanks for that HeronNS, just what I was coming around to thinking!💗Pinklady45

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