Very confused after reading the detailed report. L1. T score. -1.9. Z score 0.0
L2. T score -1.9. Z score 0.0
L3. T score 0.7. Z score 2.6
L4. T score. -0.5. Z score 1.4
LFemur Neck. T score -2.5. Z score -0.6
Total. T score -2.4. Z score -0.5
Fracture risk Major Osteoporotic 24.9%Hip Fracture. 10.4%
Glucocorticoid (chronic) Secondary Osteoporosis.
I presume this means use of steroids? Very confused with that as when the scan was done in May I had only used a 15 day course of steroids once since being diagnosed in 2004. I don’t think these scores need me to start medication so I’m very relieved.
Is the Fracture risk high at 24.9%?
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barbieg
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T-scores compare your bone density with an average 30 year old, z-scores compare with average for your own age. The starting point is zero, so a minus score shows below average, a positive score shows above average. You have very good bone density for your age, but for some reason your fracture risk is quite high. That may be because they included the steroid use in the risk calculation, which from what you say, doesn't sound correct, unless you're now on steroids permanently. Do you have any other risk factors for fracture?
Yes to a point. I had to give up Pilates and Yoga because I couldn’t get down on the floor. Exercise geared to my age (79 Saturday!) I’m sure I could do. I intend to try but wondering were they get their information from when they make their calculations. Is Glucocorticoid Steroid?
Yes, it's a steroid, presumably to reduce inflammation from your arthritis, or maybe they can help with fibromyalgia. They should have asked you a few questions about your medical history, exercise etc to allow them to do the risk calculation.
Nobody asked me when I had the scan. I think the lady I spoke to on the help line the other day said the person who writes and works out the score, look at your medical notes. Hope I’ve got that right. I Certainly wasn’t asked anything but my name , address and birthdate by the chap who did the scan. Quite where the steroids have come from I’ve no idea. I definitely had only had one course of steroids when I had my scan in May. I had another course in July, so that was well after the scan. Makes me wonder if a mistake has been made some where. No steroids for my Fibromyalgia either.
In that case I would definitely challenge the report and ask for it to be corrected! Your GP can work out your fracture risk (FRAX) score for you, or you can do it yourself: sheffield.ac.uk/FRAX/tool.aspx
The older we are, the higher the risk, so if there are no other risk factors, that could be it, though it does seem strange. I would still ask for the report to be corrected, as it says you have chronic (that means long-term) use of steroids, which simply isn't true. You also can scarcely be described as having osteoporosis - only one score just on the cusp of it! If you're able to get a REMS scan I would definitely recommend it for a second opinion and a bone strength score!
I did email the person who sent the detailed report to me last night. That’s the only contact number I have. I have thought about using the Rems but it doesn’t look like there is anywhere near me that uses it. I have a CO post code.
If you get no joy from your email, maybe you could ask your GP to get it corrected? It isn't acceptable for something to be entered wrong on your medical record.
Do you drive? If so, Waltham Abbey is probably the nearest REMS clinic (about an hour's drive), or Huntingdon is about 1 1/2 hrs. Alternatively, perhaps you could book a mini-break somewhere near one of the clinics!
My fracture risk must be 100% if that’s yours. I’m nearly 78 and have broken no bones since childhood which was the result of climbing a tree lol. My t scores are around -4 but I still refuse the bad drugs.
"Is the Fracture risk high at 24.9%?" That's the same thing I was thinking. Your bones seem to be in relatively great shape. Your L3 is above average BMD and your Z scores for your lumbar region show that you are above average for L3 - L4 when your BMD is compared to ppl your age. That's awesome. Your left femoral neck with a t-score or -2.5 is defined as osteoporosis but how they came up wiht the 24.9% and 10.4% seems to be a mystery. Have you fractured before? and what is your age? those are the only two things I can think of that might make your FRAX risk higher. Also, you L1 is missing. Is there a reason it was not included?
"I presume this means use of steroids? Very confused with that as when the scan was done in May I had only used a 15 day course of steroids once since being diagnosed in 2004." Not totally sure what you mean by this. Have you only used steroids that one time over the course of your life or only once after being diagnosed with WHAT in 2004? Osteoporosis? That's 18 years ago? and you only show osteoporosis in one are "LFemur Neck. T score -2.5"?
L 1 is the same score as L 2. I did put it down but above to the right of L 2. Sorry. I get in a muddle because I have RA which was diagnosed in 2004 and alternate between that forum and this one. I forget where I am! Shows my age of 79 today so I was referring to the steroids for my RA. I can only presume they looked at my medical records , so they need checking and correcting. I haven’t had a fracture so that can’t count. I checked my risk fracture on Frax , didn’t click the steroid button and it still came out at 24% so I presume it’s my great age and the fact I also have RA. I’m looking at it another way now , almost 25% risk of a fracture but 75% risk of NOT having a fracture. Just need to wade through the telephone queue to speak to a Dr to check my medical notes and correct them if necessary. I’m so pleased I didn’t give up trying to get the detailed report because I was presuming my scores were a lot worse and might have to give in to medication. I don’t understand how they can think we can make an informed decision on just a summary report. It read initially that my L Femur was -2.5 and my Spine was 25% worse than 2019. Meant nothing to me as I had no idea what it was 3 yrs ago. It also inferred that the -2.5 was the lesser score. I’ll know what to expect next time.
Yes, now I see that you did include “L1. T score. -1.9. Z score 0.0” and I missed it.
When I had my 2nd DEXA (1st was in 2019, 2nd in 2021) I wrote on the paperwork that I broke a toe in 2010 and my FRAX score went way up, which is ridiculous because it wasn’t a fragility fracture and I literally just chipped one of the bones in my 2 or 3 toe on my left foot. I’ll be having another DEXA before the end of this year and I’m going to get that mistake corrected.
One other question, have you lost any height. Your lumbar numbers—specifically L3 and L4–are really good. Loosing height usually means there have been compression fractures in the spine, and compression fractures skew DEXAs and makes one’s BMD appear better than it is.
At this pt, my guess is that it’s the RA. As you’ve been doing you can find and online FRAX calculator and enter different data to see how that changes the result. And you are exactly right about the 75% chance of not fracturing. The best exercises you can do to help avoid falls are balance exercises. As we age, our balance goes, & practicing balancing can help prevent this.
I read an article in the BJM a while back that pretty much said the biggest difference between who fractures & who doesn’t isn’t who has osteoporosis but who falls. Frankly, I find that hilarious but it also gives those of us with lower BMD hope. Make sure your home is set up to help you not fall—professionally installed grab bar in the shower, non-slip tub/shower surface, floors kept cleared (if you have grandkids, make them put up their toys after playing so you don’t trip). Also, I read that in Europe, it somewhat common for older adults to wear padded undergarments to prevent hip fractures if they do fall elderdepot.com/hip_protecti...
For some reason, it seems the padded undergarments aren’t as popular in the US. I’m in the US and at the moment I’m not concerned about age related falls, I’m 53 and my balance is very good, but as I age I will definitely consider using undergarments with hip pads.
Sorry, wearing padded underwear really made me laugh. Even at my great age, I don’t think I’m ready for that. My son has been here today and had a look at the 4 page report and roared his head off at the last page showing I was overweight. Only then did we notice my weight was down as 62 k . I’ve never been that and stick around 52. I’m short and slim. How they can class me as overweight I don’t know. It’s the BMI but even then the only fat I have is on my stomach which I’m very grateful for when I start my Biologic for my RA. Good points about the floor. I do need grab rails over my bath . I have a Bath board which works well as my shower is over my bath.
The balance exercises I really want to start but I’ve got a really painful ankle/heel at the moment and waiting to see a physiotherapist. My friend has done Tai Chi for years and a lot of that is balance and lots of the movements are good for Osteoporosis so she’s going to help me. Thank you for all your info and help.
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