Dexa scan results -L2 & L3 excluded ?

[Cat_bluenote]

Hi everyone, I recently had a private Dexa scan which diagnosed osteopenia. The report also said- " L2 and L3 were excluded from the analysis due to sclerotic changes? Spondylosis? or Fracture?"

It wouldn't surprise me if I've had a fracture, as I've been in constant pain with my back for 9 months and GP only sends me for physio and gives painkillers.

It said to share the results with my GP, and that they should investigate. I'm wondering what checks my GP should do? Just asking because I don't have much trust in them. Has anyone else had anything like this in their results? 🙏🏼

[Fruitandnutcase]

Hi, welcome to this very good group. You should probably phone or email the ROS and speak to one of their nurses, I’m sure this is something they could help you with.

[Cat_bluenote in reply to Fruitandnutcase]

Thanks, yes I have already done that, and the nurse was very helpful. I know I will have to see my GP, but I just wondered how common this type of thing is on Dexa results, or if anyone else had similar and what their GP did.

[Lopera]

Hi

I had exactly the same with my GP. For 2 years running I went with terrible back pain and was told to take painkillers and have physio. The first year, the pain lasted about 3 months most of which time I slept in a reclining chair. I was given the same advice the second year and eventually had an MRI privately showing 6 spinal fracture, 3 of which were old. (My GP had declined my request for an MRI, preferring me to try osteopathy!).

I would ask your GP for an xray or MRI to confirm whether you have fractures or not as this may affect how you deal with this going forward.

I found that painkillers only took the edge of the pain but a heat pad was very helpful.

I hope you can get some answers and some relief from the pain.

[Cat_bluenote in reply to Lopera]

Thanks, Yes I think I should ask for an MRI.The painkillers I have aren't great either, but I do use a heated jacket in the evening.

Can I ask, were you aware of doing anything in particular to cause the fractures?

[Fruitandnutcase in reply to Lopera]

I asked a GP for an X-ray because of pain in my pelvis following a freak fall where I flew through the air backwards and landed on my bottom onto the ground that had been baked hard like concrete. I was in so much pain and could barely hobble.

The doctor who was a locum, someone I had never met and who knew nothing about me - told me I could not have an X-ray ‘ the hospital was too busy’ (it was in summer 2021 and Covid was still around) and even worse - that ‘you probably just had a touch of osteoarthritis, it is quite common at your age’.

Two private MRIs later (lumbar area and MSK pelvic scan) and it turned out that I had a fractured sacrum, no wonder I could barely walk and was in a lot of pain. There was absolutely no way I would have got anywhere if I hadn’t paid for my scans myself.

I don’t suppose it matters to some doctors - the treatment was the same anyway - for me it was time, gentle exercise and painkillers but the fact I couldn’t even get anyone to do an X-ray seemed pretty awful when I was in so much pain.

[Lopera in reply to Fruitandnutcase]

I can imagine the pain you were in, must have been excruciating. What surprised me when I went for a private MRI was the number of people doing exactly the same. The waiting room was packed. It seems many people are finding it difficult to rely on the NHS.

[Cat_bluenote in reply to Fruitandnutcase]

Oh my goodness. That is shocking! Some GP 's! 🙄

[Lopera]

No, absolutely nothing. I felt they came out of nowhere.

[Cat_bluenote in reply to Lopera]

Thanks. It seems strange, how that can happen 🤷🏼

[Lopera in reply to Cat_bluenote]

When I saw a spinal surgeon, he said it could happen with a bend or a twist or a sneeze. I probably did it gardening but I really don't know.

[Cat_bluenote in reply to Lopera]

Do you have osteopenia or osteoporosis? Or could it happen without that?

[Lopera in reply to Cat_bluenote]

My dexa scan results were spine -2.8 and hip -0.5 so hip normal and spine osteoporotic. This is known as major discordance so usually thought to be an error. I recently had a REMS scan which gave me very different results. Hips were -1.9 and spine -1.8 if I recall correctly but osteopenia rather than osteoporosis but the fact that I have fractures means de facto I have osteoporosis and am treated as such.

[Cat_bluenote in reply to Lopera]

My spine score was -2.0, and hip -1.8. I'll see what GP says about it. They'll probably say it's normal, and I'm fine.!

[Lopera in reply to Cat_bluenote]

I would make sure to be getting sufficient calcium and vitamins D3 and K2 and to do weight bearing exercise if you are able to.

[Trec in reply to Cat_bluenote]

I think -2.0 is Osteopenia isn’t it?

Mine says that spinal BMD result is falsely elevated due to degenerative changes and/or vertebral deformities throughout the lumbar region and the true spinal BMD result is likely to be lower. I know I have Spondylolisthesis. I’m presuming lower means better but am not sure as have only very recently received my printout of my DEXA results. I had to make a GP appointment to ask for it as all I had was a text message saying the scan had confirmed I had Osteoporosis.

[Cat_bluenote in reply to Trec]

Thanks, Yes, Minus 1 to minus 2.5 is osteopenia. I'm new to all this. I got the scan because of having lost a little height, plus my mother has osteoporosis, I ve had low back pain for a while but don't have any diagnosis yet. I just keep getting referred to physio, and painkillers. Also I'm on a medication that could cause osteoporosis, and so wanted to know how things were now.

[CinnamonRose in reply to Trec]

Yes it's crazy, in theory I should' just' have Osteopenia from my scores and yet I've fractured 7 vertebrae, so far in the last 5 years, it doesn't make sense!! so they told me I've got Osteoporosis and brittle bones🤷🏽

[Cat_bluenote]

Thanks. Yes I've started to do that.

[Fatpidgeon]

Hi Cat_bluenote,

I have had several CT scan reports that include the phrase "no sclerotic bony lesions", which to me would suggest that it is important that it is checked out and any nasties excluded. All the very best.

[Cat_bluenote in reply to Fatpidgeon]

Thanks, that's helpful. Going to try and get an appointment tomorrow.

[Trec in reply to Fatpidgeon]

Is that not a good thing? I confess I’m only just getting acquainted to the terminology of the scans. The GP I asked for the written report mentioned a score of 16 but I can’t see any mention of that on the report so am confused and have no idea what that number refers to. I tripped and broke my pelvis last July which is why I had the scan as had no idea I had Osteoporosis and was reluctant to accept I did especially as the Alendronic Acid tablets the hospital gave me made me very unwell and ended up back in hospital with Colitis.

[tangocharlie]

Insist on a spinal x-ray and show your GP the note. My fractures were missed by my GP, two physiotherapists and in A&E for over a year until I finally had the x-rays which showed 4 fractures

[Cat_bluenote in reply to tangocharlie]

Thanks. The ROS nurse said an MRI would be best as an X-ray would not show anymore detail than the Dexa did - which is similar to an x-ray. But GP s are reluctant to send you for MRIs. I'm dreading going really, as I feel I always get fobbed off. 🤞🏼I get some answers.

How are your fractures now?

[tangocharlie in reply to Cat_bluenote]

Hmm I think there might have been a misunderstanding there in your conversation. For fractures x-rays are usually better, but MRIs (possibly with contrast) might also help. In my case it was the x-rays that were conclusive, they clearly showed the wedge fractures and kyphosis. Dexa scans do not look at the state of your bones, they only give a very rough idea of the density of them. They can't get a good reading if there are fractures etc

[Cat_bluenote in reply to tangocharlie]

Ok Thanks. I thought she said that, but maybe I was mistaken. Or, is it possible that an MRI would be better at identifying Sclerotic changes or spondylosis? My report mentioned either of those , or fractures as being the cause of some abnormality in the bone? I'm hoping it's not anything malignant!

I'll just have to go along with whatever GP suggests.

I value everyone's thoughts, as I know nothing about any of this. It was my first Dexa.

[tangocharlie in reply to Cat_bluenote]

Could be that you need a few different scans with several things going on. Like you say, over to your GP, and maybe a specialist referral. Onwards and upwards eh

[Cat_bluenote in reply to tangocharlie]

Thanks. I've now been to GP. Sent for x ray, vit D and bone blood tests. Waiting for results, 🤞🏼I get some help.

[tangocharlie in reply to Cat_bluenote]

Excellent, sounds like a good GP and good plan

[CinnamonRose in reply to tangocharlie]

Preferably a standing x-ray, they seem to show up better when standing, unless it's just me!

[ROSModerator Partner]

Hi Cat_bluenote ,

Just popping in to wish you a very warm welcome to our community, thank you for joining us here It's great to see you connect with our wonderful members, and we hope our community helps you to not feel alone in your health journey

It looks like you have already accessed some of our resources, but just in case, we have lots of information and support on our website: theros.org.uk/

Wishing you the very best,

Lulu

ROS Moderator

[Cat_bluenote in reply to ROSModerator]

Thank you