Dexa help

[jacquette]

Hello,

I am a DEXA Radiographer

Dexa is used to measure and calculate the risk of osteoporotic fracture.

Dexa is used for a wide range of people using Prednisone as prednisone CAN (dependant on use and dosage) reduce your bone density, however a lot of other 'secondary' risk factors will be measured too, such as your past medical history, your health and diet etc.

The score you get will compare yourself with others of your age, gender and ethnicity and give you a reading from the normal (or your categories average), meaning a T-score of + or -

Prednisone has a small part to play in reducing your bone density, thus your risk of developing osteoporosis. It is therefore important that you have a healthy diet and exercise.

Cheers

Jac

[charisma]

Hi Jac

I see you also have RA. Are you in the USA/Aus/NZ?

In the UK we are usually prescribed Prednisolone, if needed. It is easier on the liver.

When I went for a DEXA scan late summer of 2019, nobody bothered asking about diet and exercise.

I hope you are on top of RA at present. Are you working during this pandemic?

[jacquette in reply to charisma]

No, im based in the UK and have been a DEXA Rad for 8years across 5 counties. The questionairre you or given or the Radiographer should ask if you do weight baring exercise ie you are not wheelchair based and can exercise on your feet. And if you have eat/ drink diary? Tge rest of the questions are Medical history and Family history

[charisma in reply to jacquette]

No questions at all, no forms to fill in. Just referred by Rheumatologist.

[jacquette in reply to charisma]

This is not the way a DEXA Radiographer is trained. The questionairre can change the T-Score, thus diagnosis.

[jacquette in reply to charisma]

And yes, all on top of my RA at the moment.

I am aware of the effects and reasons for prednisolone, however some people are on higher doses for long periods of time which xan have a greater impact on you bone density than others, but again, prednisolone is taken for many medical reasons and people might be on it all their lives.

Im also a CT Radiographer, so working at the moment, but only for a few more weeks as im off on Maternity leave with my first baby.

[helixhelix]

It used to be that DEXA scans were automatically offered to women over 55, and others with risk factors like smoking and steroid use. I certainly had one. I don’t know if this still happens as no longer live in UK.

[jacquette in reply to helixhelix]

DEXA should be offered to anyone over 50 who has had a 'non traumatic' or major fracture (such as hip). Is taking Aromatase Inhibitors (Breast Ca treatment), is on long term steriods (prednisolone) of more than 5mg for 6months +, and other specific medical issues.

And to anyone over 70, with family history and a secondary risk factor

[helixhelix in reply to jacquette]

A shame that automatic screening has stopped. Seemed a useful preventative measure to me.

[JFlay in reply to jacquette]

My rheumy calculated my risk at my last appointment, I'm 59 and on hydroxy, not on steroids, otherwise fit and well. I was surprised that she referred me for a dexa scan. Unfortunately it was cancelled due to the current situation 😕

[charisma in reply to helixhelix]

I never got one till age 65+. So guess not, although it probably differs across Health Boards.

[sylvi]

Thank you for explaining that to us. A lot of people don't know what is involved with it due to probally being newly diagnosed. xxx

[happytulip]

I had to ask my GP to arrange a Dexa scan for me. I've been on high dose pred for 5 years and no one had bothered to think about it. I'm 38 but I've had high dose for a long time plus IV steroids and IM. It came back showing osteopenia.

I was advised to by my GP to get plenty of sun because of Vit D. To take plenty of dairy and to do alot of walking.

It made me laugh because I had to point out that I am severely intolerant to the sun (gives me organ inflammation), dairy allergic, and I have EDS and pericarditis so can't walk far.

Fortunately, I had done my research and knew I was able to get a gym referral to my local gym to just slowly walk on the treadmill in a safe place where I would be ok if my pericarditis played up.

I was also the one who asked to be out on alendronic acid and Adcal 5 years ago too. GP wasn't particularly switched on with that one.

Thanks for the info.

[Fra22-57]

How often should you have a dexa scan please. I am on long term steroids. Last one was before 2018. I do know a few years ago I was asked to have a break from taking vit d too as told it stops working after so long.I m niwxtaking it again.I I right in thinking you should take alendronic acid aswell as this makes vit d go to bones

[jacquette in reply to Fra22-57]

Depends if you are Osteoporotic

If your blood test says your vitamin D is low, but your diet contains calcium, you are healthy and your DEXA is normal for your category, then you may not need Alendronic Acid.

Lack of Vitamin D means that you cannot absorb calcium properly.

If now that you are back on Vit D, your bloods say they are normal, then you should have a balanced calcium intake too, which will protect your bones and thus prevent OP.

[Fra22-57 in reply to jacquette]

Many thanks for very informative helpful reply jacquette

[jacquette]

Every 3 years is the general recommendation

[Biofreak]

I have a dexa scan every 3 years. I was diagnosed with osteoporosis before I was diagnosed with RA strangely enough. At the time I had never taken Prednisone but was having crippling shoulder pain. My mum had osteoporosis and RA but she only discovered that she had osteoporosis after part of her spine collapsed. When she passed away I asked my GP if I could be checked and thankfully he referred me. I was 40 at the time. My osteoporosis was put down to early menopause. I was immediately prescribed Adcal and later alendronic acid. I believe that early intervention saved me from suffering the same fate as my mum. Having said that, if I hadn't asked my GP for a referral, it may have been different. Best wishes to you Jacquette with your first baby.

[jacquette in reply to Biofreak]

Thank you very much....

A strong Family History of Osteoporosis, especially on the maternal side is a high risk indicator.

It can be difficult to get DEXA scans outside of your Rheumy unless your doctor is pro OP checks and aware of OP risk factors.

[Biofreak in reply to jacquette]

My GP at the time was always very proactive, thankfully, to his credit. I told him about my mother and the history of RA and osteoperosis on my mother's side of the family and he was very understanding and didn't put up any resistance.