Any opinion on discordance of t scores

[Bubba3xt]

Hi. I'm a 67 yr old woman and just found out from test I have osteoporosis. What I find curious is my t score for femoral neck is -2.9 forearm is-.4 and spine is +.6

I don't question the results. I have had aches in my hips when laying on them for quite a while and very stiff after sitting a while. I do think something is going on with bone production or lack of that is more localized and not necessarily diet related because the rest of my body seems to be doing ok at bone production. I have a doctor's appt next week and would like to stay off any meds if possible and just trying to arm myself with as much knowledge as I can. Anyone else have experience with this kind of discordance?

[HeronNS]

Do you have osteoarthritis in your spine as this can affect DXA results?

[Bubba3xt in reply to HeronNS]

I don't know if I have osteoarthritis.

[Bubba3xt in reply to Bubba3xt]

I have been taking a joint supplement, assuming hip ache is arthritis and it has helped when standing up or getting out of the car. Ironically I started taking that the day before they called with op diagnosis.

[restlesspegs]

Over 1 S.D. difference between spine and hip usually requires further investigation. I had a REMS scan which turned out to show my hip with a score far closer to my spine score (better). I'm going to have another DEXA scan soon to verify if there was some issue with the original scan.

[yogalibrarian]

One explanation I've heard is that your spine t-score is indicative of your activity during your peak bone-building years (childhood to mid/late 20s). The hip t-score is more indicative of more recent osteogenic loading (since menopause).

I agree that spinal arthritis or previous spinal fractures could make the bone density appear higher than it actually is. (Is this your first DXA? Or did you have an earlier one that you can compare?)

[Met00 in reply to yogalibrarian]

That wouldn't make sense for me. My spine score with DEXA was much worse than my hip score, but I was very active as a child/young adult. When I had a REMS scan (which is more reliable than DEXA because it isn't open to the same positioning and operator errors), my scores were very similar for both. Many experts consider that there shouldn't be more than 1 standard deviation between spine and hip, unless there are specific reasons, such as being wheelchair bound or having osteoarthritis in one area and not the other (the latter makes bone density look better than it is with DEXA scanning).

[Met00]

With DEXA scans, it's much harder to get an accurate femoral neck score because it's a very small area. Total hip is generally considered more reliable. Osteoporosis itself isn't normally painful unless you've fractured - you can get pain from the causes, such as low Vitamin D and/or hyperparathyroidism, but that's more likely to be widespread pain rather than limited to a specific location. The pain and stiffness in your hips could well be due to osteoarthritis, but it would make sense to ask for it to be investigated, if nothing else to rule out fractures.

[Bubba3xt]

This was my first DEXA and the only bone I've ever broken was in a serious accident when I was 42, not low impact. At the time I was unconscious for hours so they x-rayed everything and the next day the doc told me I'd never have to worry about osteoporosis cuz I had the densest bones he'd seen. That's why this was the last thing I expected to hear. I just measured myself, cause they don't do that at checkups and I'm an inch shorter than in my 20's so I don't think there's really anything going on with my spine but I do think there's something with hips. Thanks for all your input. I'll have to see what the doc has to say.,

[CathyCA]

Bubba3xt, I have a similar discordance in T-Scores. I am 70 years old. My recent DEXA shows Femoral Neck of -2.6 and AP Spine -0.8. This is similar to scans in 2019 and 2017. Comparison of the 3 scans show degradation of Femoral Neck over time and improvement in the spine over time. I searched for reasons and one that came up for me is that I have mild idiopathic scoliosis, it runs in my family. I read that scoliosis can interfere with the DEXA accuracy as can osteoarthritis. I asked my doctor for an xray and evaluation of my spine (thoracic spine). It showed the scoliosis, mild degenerative spurring (osteoarthritis), and Osteopenia. From that information, I agreed with proceeding with the Femoral Neck score as being the most reliable indicator that I do indeed have the beginnings of osteoporosis.