Last year I had an Echolight scan and the results were better than my DEXA. Unfortunately the provider in NJ who did the Echolight left the practice and they are no longer doing it. Does anyone have experience with having had an Echolight scan? They are commonly done in Europe and said to be much more accurate than DEXA. I see very few locations in the US were you can get the Echolight scan done. Most doctors don't even want to know about Echolight. Any comments or experience regarding Echolight is appreciated.
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I live in the UK and have had two REMS (Echolight) scans. My first one was 14 months after a DEXA scan and gave me t-scores of -2.6 in both hip and spine, compared to my DEXA scores of -2.5 hip and -3.6 spine! Unfortunately the NHS can be very slow to introduce new technology, so REMS isn't officially recognised here, though some doctors are happy to accept the results. There's certainly plenty of research that shows its reliability and accuracy - when done properly, both REMS and DEXA give similar results, but DEXA is much more open to operator and other errors. REMS results from different machines are comparable, whereas those from different DEXA machines aren't (which in itself raises questions about DEXA, because if two different machines give different results, how can you possibly know which one is correct?!) Unlike here in the UK, REMS has been accepted for diagnostic purposes in the US, so I'm puzzled why your doctors aren't more open to it!
Thank you for responding. May I ask if you are taking medication? I'm really afraid to take anything as I have a friend who ended up with jaw necrosis. My results on the echolight are similar to yours on echolight.
I took meds for a year when first diagnosed nearly 8 years ago, but I was wrongly advised by my GP because the DEXA report actually said meds weren't necessary! I stopped because of the side effects and haven't taken anything since, just relying on exercise, diet and supplements. I haven't had any fragility fractures and don't have any other risk factors for osteoporosis, so my FRAX (fracture risk) score is relatively low. It's your fracture risk that's more important than t-scores, although FRAX risk assessment does take these into account. There's another fracture risk tool approved for use in the UK (but rarely used), which doesn't include t-scores yet is claimed to be more accurate than FRAX. It's called Q-fracture and you can find it here if you want to try it: qfracture.org/index.php
It really depends how you perceive risk. 12.1% risk of fracture is 87.9% chance that you won't fracture. I think I'd personally take my chances with that, but it has to be a personal decision!
I agree with you . I would like to next either get a dexa with tbs or Rems test. What do you think ? My mom broke her hip at 88 and had never taken OP medicine and had a positive recovery. It seems those not on medicine recover well should they break. I don’t understand how the doctors say but if you had 20 year old bones you might not have fallen or broken a bone if you fell.
The main point should be, If you have OP and take medicine, and fall and break a bone you might not recover well because you have brittle bones. But the doctors are saying you don’t want frail bones. And that’s why you should take medicine. Which I agree you don’t want frail bones. But they don’t give the option to try supplements and more intense exercise route when real softer bones are safer ( even my mom is an example of your own bone healing well)
I would choose REMS be because it's more reliable than DEXA, but in the UK that means going privately because you can't get REMS on the NHS. The meds do reduce fracture risk, though not by a huge amount, and with bisphoshonates that's only taking them for three years, with no proven benefit if you take them for longer. Also the main cause of fracture is falling, so reducing your risk of falls is more effective than taking meds!
I'm in the US, and after learning about REMS on this website, I emailed Echolight Medical to see where their equipment is available in the US. I received the reply below. Unfortunately, none of the locations are in my state. Note, you might want to look into getting a TBS (trabecular bone score).
I am Vicki Baldwin, the Clinical Application Specialist for Echolight Medical, USA. I was given your information because you inquired about being able to find a facility in your area to have a scan performed.
Currently the sites that are available for clinical scanning of patients are in New Jersey (2), North Carolina (2), and Maryland (1). We are working very hard to get the word out of our newly open US operations, and we will update you of any openings near you if you want to be included on our mailing list! I am attaching a pamphlet of information meant to be printed and share with your Doctor.
Below are sites available for REMS exams:
Dr. Kimberly Zambito ( Orthopedic Surgeon)
Mercer-Bucks Orthopedics
Lawrenceville, NJ
855-896-0444
Dr Andy Bush ( Orthopedic Surgeon)
Central Carolina Orthopaedic Associates
Sanford, NC
919-774-1355 (ask for James)
Dr. Edmund Maclaughlin (Rhuematologist) and Dr. Curtis Foy (Family Medicine)
Rheumatology Associates of Delmarva
Easton, MD
410-819-6545
StrengthX
Dr. Mike Lewen (Chiropractor, Exercise Science)
Asheville, NC
828-505-7200
(Brand new location, call for scheduling information)
XBody Health, Wellness, and Spa (Bone Density only, Bone Quality currently not available)
Wayne, NJ
973-869-5806
Locations coming soon: Lubbock, TX; St. Louis, MO. As stated above we are in talks with many more and will update this list as they become available.
A company called Medimaps Group* markets the TBS software. You might be able to find information from them about providers who use TBS with their DXA machines.
*Medimaps Group is a one-time member of the American Bone Health Corporate Advisory Board.
I recently watch a webinar on bone turnover markers--If you are interested in knowing more about bone turnover markers, go to my bio and there are 2 links, one is to a list of tests that should be done to rule out secondary causes of osteoporosis, the other is a pdf about bone turnover markers. During the webinar, the speaker mentioned that for smaller ppl DEXAs can be wrong and to get a better idea of bone strength it's a good idea to have a TBS. I researched how to do this and apparently, there is software that can be downloaded to DEXA scanners. There is the possibly that the place that you get your DEXAs done already has the software and therefore has the capability to do a TBS--it's not a separate scan, it is done at the same time a DEXA is done.
I'm 4'11" and currently weigh 106 lbs. and after listening to the webinar I decided that I was interested in having a TBS included with my next DEXA if possible (my endocrinologist should have ordered a TBS yrs ago but he leaves a lot to be desired). I've sent an email to the facility that did my last 2 DEXAs asking if they have the capability to do the TBS. I'm not really thrilled with this imagining center but everyone recommends having DEXAs done on the same machine so I thought I would try them first.
I had an appt with my endocrinologist yesterday, and asked him to include a TBS and forearm scan on my DEXA referral. Then I drove over to the imaging facility gave them the referral, told the person that I had sent an email to the office admin over a week ago and was waiting on a response about whether or not they are able to do TBS and forearm scans. The lady at the front desk said they would have to get back to me. Later, the person I'd spoken with left me a message saying that she'd spoken with the radiologist and all they do are TBS scans--LOL. Reason I am telling you all this is that it really depends on the facility that you use and unfortunately I picked a circus. I'm not sure if the woman meant to say they don't do TBS scans but TBS scans are not all that they do. I've had two DEXA scans done at the facility and there is no TBS on the full reports I was given.
I had a lot of trouble getting my full 2019 and 2021 DEXA reports and the ancillary data from this imaging center and the fact that they don't know that DEXAs don't typically include TBS might be the icing on the cake--I might be forced to find a new imaging center to use for my next DEXA.
I took an older relative for her DEXA last March. She lives a couple of hours away but I go up periodically to help. The know for a fact that that her imaging center recently updated their DEXA machines and since we are in the same state, as long as they take my insurance, I could have my DEXA scan done there; however, it does require a 4 hour trip and the machines they use are Hologic. My 2019 and 2021 scans were done on GE Lunar. It doesn't really make a lot of sense but there is an issue with comparing data between the two pieces of equipment.
So long story short. You will need to ask your doctor to include a request for a TBS on your DEXA referral and you will need to verify with the facility that they have the capability to do the TBS.
Your TBS will really give you a better idea of your bone strength/fracture risk. My first DEXA showed that my lumbar spine is -3.9 and my hips are both around -3.1. I am very active and to date, I have no fragility fractures. There are ppl with better BMD scores who have lots of fragility fractures. There has to be more to bone strength and whether or not you are likely to fracture, than just your BMD t-scores.
My two cents on why so few Echolight machines in the United States - money! The more women diagnosed with osteoporosis due only to bone density score from the DEXA machines - not bone strength from Echolight machines - these women become lifetime patients for the doctors - and the pharmaceutical companies. Always follow the money.
Or it could be that the REMS machines are costly, most insurance will not cover their use, and facilities have already invested huge amounts of money in their DEXA machines, so it would be irresponsible of them to invest more sums of money in a different system that they won't be paid to use. If and when it's proved to be MORE predictive of future fractures (which of course takes decades to find out), I suspect insurance companies will start to cover it and then more facilities will be able to offer it. I don't know the truth, but it's a theory.
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Information about REMS Echolight scan for osteoporosis
Dexa scan results
Dexa shows left hip worse
Getting the doc to order a DEXA
