Cat scan vs DEXA scan

[Kitchenbuddy]

I had a CT scan in December for another issue not having anything to do with my bones and after I left the hospital I was reading my records to see what alk I had done. I came across a report that diagnosed as having Ostropenia which if accurate is better than severe osteoporosis that

[Kitchenbuddy]

Whoops, I tapped something wrong and posted before I was finished. My DEXA scan report came back with severe osteoporosis several years ago. I refused to take meds due to possible side effects and I am moderately active, other than that I have not extensively done anything to change my bone health. I try to eat healthy, but it's not super great. For the most part I am doing well at 68. Which is correct,I wonder the CT scan or the DEXA or someone is not interpreting the test right. I just go day to day and try not to worry.

[FrogLeg in reply to Kitchenbuddy]

Hi. I am confused by your post. What did you mean by “alk”? When you say you came across a report, can you be more specific and clear about what kind of report you mean?

[Kitchenbuddy in reply to FrogLeg]

Sorry, Alk is a typo. I had a CT scan that indicated I had osteopenia instead of osteoporosis which was indicated as a result of a DEXA scan many years ago. Osteopenia would be an improvement for sure if the health records are accurate.

[FrogLeg in reply to Kitchenbuddy]

A CT scan isn’t used for diagnosing osteoporosis. Dexa is the gold standard as it is designed to specifically to determine BMD (bone mineral density). A CT isn’t designed with that singular purpose in mind. You can get a sense of skeletal quality and degeneration from a CT, but not in the same quantitative way that a Dexa provides. The CT report writer likely uses terms like “osteopenia” to give a quick qualitative sense of degradation. But a CT doesn’t provide any standardized measure at specific sites to then generate T-scores for statistical comparison to other people.

Regular readers of this forum will rightly point out that a Dexa itself is a flawed measure of bone “quality”, which is something of a nebulous or ill-defined term intended to capture all of the factors that could relate to the potential for a bone fracture. That is, BMD is not the only factor in assessing whether someone may ultimately have a fracture.

I would not try to compare a CT to a Dexa in any way in terms of diagnostic value. You might want to have a fresh Dexa scan. Or talk to an endocrinologist about your osteoporosis.

[Frodoles in reply to FrogLeg]

Not sure where you are but here in UK yes the Dexa Scan is the Gold Standard. However I would dispute that. It only measures density and not how fragile it is. I had a REMS scan at Osteoscan.uk with Nick Birch FRCS (Orth) I had been diagnosed with Osteoporosis more than ten years ago. I too didn't want to take the medications. But had taken supplements of course. The results showed I only had osteopaenia. My fragility score was far better than I expected. Whilst the NHS continues to say the Dexa Scan is the Gold Standard I am afraid some people end up on these medications when they really don't need them and let's face it there are side affects.

[Kitchenbuddy in reply to Frodoles]

I agree. I feel strong and I am very active. Thanks for your input.

[FrogLeg in reply to Frodoles]

Yes I was trying to explain just what you mentioned about fragility or quality. I have little faith in REMS for various reasons I have elaborated elsewhere. I realize DEXA is not perfect either. Maybe in time diagnostics will improve.

[bonewarrior in reply to Frodoles]

I totally agree with you, Frodoles. Same here in Germany. REMS is not widely available, only in two or three locations throughout Germany. Dexa is considered the go to scan and results in medication prescription but no discussions about alternative ways. I have osteoporosis and a new Dexa coming up in two weeks after not taking medication but supplements and weight bearing exercise for two years. If my osteoporosis has not stagnated or improved, I am seeking out the available REMS scan here in Germany as second scan option.

[Pvane in reply to Kitchenbuddy]

Hello, I have found that specific weight bearing exercises can actually help by strengthening muscles and keep you from losing bone density. I work out daily and walk daily. My DEXA scores have improved over the course of a year. The owner of the fitness group that I belong to will do a consultation with you by phone. She is an expert in exercises for osteoporosis and seniors specifically. Here is the link to her contact information. The consultation is free.

activitiesinmotion.ca/contact/

[Kitchenbuddy in reply to Pvane]

Thank you. I am a rehab therapist and also do exercise daily.

[yogalibrarian]

The standard for diagnosing osteoporosis is diagnosing. A cat can't do that and can't be used for comparison. I can suggest you need a dxa.

[MammaGoop]

I had a Dexa scan in January that shows that there is osteopenia in my spine, highest level before osteoporosis. My arms are fine, results on my legs no clear as I have bilateral hip replacements. I also suffer from Reactive and Rheumatoid arthritis for which I take a low dose of a chemo drug and Hydroxychloriquine. I was prescribed Alendronic acid for the osteopenia plus a calcium and vitamin D tablet. Wasn’t keen for more drugs but don’t want the osteopenia to get worse as I am unable to do a great deal of exercise. I haven’t had a problem with the Alendronic acid and have been told I will be on it for five years when they will rescan and review by which time I will probably have two new knees too! A CT scan has nothing to do with bone density so I would question what your records are saying and get a new Dexa scan done.

[uncountable3]

"Osteopenia" on a CT scan is not the same thing as "Osteopenia" on a DXA. It means low bone density severe enough to show up on a regular X-ray. It is not better than what DXA showed. It is actually a less precise confirmation of the osteoporosis shown by DXA.

[Southerngirl2787]

I asked my surgeon once when he used the term "osteopenic" to describe the bone post surgery....he said, it's one term, for any condition of the bones. He says DEXA is flawed, CT he uses to look at the bones before surgery, MRIs when nerves are going wonky, fractures, and disc issues. That said, I rely on his views of my bones, he sees them too often.

[Kitchenbuddy in reply to Southerngirl2787]

I wonder the same about Dexas. U don't have bone pain associated Sith osteoporosis only some in the upper back that goes away with rest. I know a

[Kitchenbuddy in reply to Kitchenbuddy]

Sorry I touch something on here that post before I want to. I keep active and don't have a lot of pain like someone with severe osteoporosis would. I have refused meds for years so I don't think I need them. I just hope people can trust test results.

[Southerngirl2787 in reply to Kitchenbuddy]

I've questioned testing results for years. All of them. I've had MRIs, described specific pain, then fast forward to post surgery and surgeon always, always says, it's worse than the MRI/CT scan showed. I've had discs that are bone on bone in several places that the MRI doesn't show that bad. My most accurate tests are CT Spect. I've now had 10 fractures, so DEXA is worthless for me. I think we are happier without the DEXA, as so many take the awful OP meds and get no where with density.

[Kitchenbuddy in reply to Southerngirl2787]

I agree with you. I do not like medication and refuse to take it. My GI specialist always says get what you need through nutrition.

[suzanne970a]

Once bones are diagnosed via a DXA scan with osteoporosis they never go back to normal. You may have another scan that will show the density has improved and you have come out of the osteoporotic stage. I was diagnosed with Osteoporosis in my 40's i choose also not to have the main meds due to side effects but opted for hrt instead, this is also taken with Adcal D3 - if you are still not taking anything I hope you are at least taking your prescribed calcium/vit d combo.

We have a very high level of osteoporosis in the family nan broke her hip, my aunt also she is now bed bound and my mum this year broke her back. Its more common in females and there are also other factures, certain medical conditions, early menopause, thyroid, small stature and many more that also put you at risk.

Please consider taking something lifestyle alone will not manage it all the time. I'm not sure where you are located but in the uk we have these scans every 3 years, you dont mention if you have had a follow up dxa scan.

[Kitchenbuddy in reply to suzanne970a]

Thank you. I take a calcium supplement with Vitamin D3 and K2. I just won take the prescribed medication. I have heard too much negative in regards to them.