AA and Dexa scan

[Marlenec]

Does anyone know of medical documentation that says to have a Dexa scan before taking AA or when diagnosed with PMR please?

[Zofitmogelijk]

Marlenec, since I am dutch, can't say much about the protocol in your country. But please read my post, and the one before, to convince you iT is worthwhile to have one. My gp did not want to refer me to radiologie for a dexascan, and I asked again the next day. Hope for Good results for you too the bones are yours and Precious. Good luck, Aletta

[Marlenec in reply to Zofitmogelijk]

Thank you, yes I have just read your post and the replies. I shall push for the scan.

Good luck with everything!

[Rugger]

Marlene, Go onto the PMRGCA.co.uk website. Click on 'Research' on the left hand side. A drop down box gives you the option of 'Guidelines', which leads you to a page where you'll see a link to the 'British Society for Rheumatology' guidelines. On page 3 of those guidelines it says for 65 or over, to start a bisphosphonate without a DEXAscan, but for others, presumably under 65 to do a DEXA scan. I hope you can use this to your advantage, or keep quiet about it if you are 65 or over!

Let us know how you get on. I've been there and had my scan 9 months after diagnosis / pred and it showed osteoporosis - I'll never know if it was there pre-pred or not. Take care.

[PMRpro Ambassador in reply to Rugger]

I do find the age limit irritating - I know 2 ladies on the forums, one is well over 80 now and the other in her late 70s, and both have far better bone density that I did at 57! The assumption that all elderly people have osteoporosis is infuriating!

I've just had the bisphosphonate discussion with a new doctor! She looked horrified when I said she could save herself the task of looking in great detail at my recent dexascan (which is excellent) because whatever she decided I would not be taking a bisphosphonate. The job of explaining my justification was made more difficult because I usually do it in English - the German words were missing for doing it off the cuff...

[Marlenec in reply to Rugger]

I'm 70, just posted my visit to GP. Thank you for your support.

[PMRpro Ambassador]

pmr-gca-northeast.org.uk/as...

These are the BSR recommendations for the management of PMR. In Recommendation 6 on page 5 they say:

"Other individuals (i.e. under 65) should have an adequate intake

of calcium and vitamin D (Grade C). We recommend co-prescription of calcium and vitamin D supplements when starting corticosteroid therapy. Measurement of BMD to assess fracture risk is recommended in these individuals as well. A bone-sparing agent may be indicated if T-score is -1.5 or lower."

[Marlenec in reply to PMRpro]

Thanks I have just posted my visit to GP with good results!

[Nap1 in reply to PMRpro]

My T-score indicates Osteopenia. Bottom of the chart. A. CAT scan of my lumbar spine indicates small fractures and severe osteoporosis with a host of other issues. My calcium level and vitamin D good and I do take supplements.

My Dexa scan only showed the osteopenia and I feel most do not show enough. I'm not doing too much more because of the fracture but I am doing physical therapy and getting Prolia shots. The AA sent me right to the emergency room where they took an ultrasound and stress test thinking the severe pain was my heart. I did take fosamax as a younger person and did ok. It kept the bone problems at bay for a long time. Not anymore. Prolia has no side effects for me. By the way. Not too much pain from the fracture. Arthritis pain much worse. Not good DNA. Thank you universe and biotech for steroids. Just sharing.