I had a DEXA san in January 2022, 18 months after being diagnosed and starting on Pred.
By then my usual GP was away. I was just told I had osteopenia. I’m 65. For several months I wasn’t even advised what to do about it until I spoke again to my regular doc, who prescribed soluble ADCAL D3. But somehow I never got the detailed results from her.
At a recent 5-yearly face to face checkup with the nurse, I got her to print out my results. I think I understand them but can someone more in the know interpret the front page summary for me, please?
Or is that not the done thing, to post medical results? I’ve redacted the clinicians’ names.
thanks.
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Did you mean to attached a picture? So long as there is no personal information should be okay….
But more info - if you need it -
A bone density scan compares your bone density with the bone density expected for a young healthy adult or a healthy adult of your own age, gender and ethnicity.
The difference is calculated as a standard deviation (SD) score. This measures the difference between your bone density and the expected value.
The difference between your measurement and that of a young healthy adult is known as a T score,
The difference between your measurement and that of someone of the same age is known as a Z score.
The World Health Organization (WHO) classifies T scores as follows:
* above -1 SD is normal
* between -1 and -2.5 SD is defined as mildly reduced bone mineral density (BMD) compared with peak bone mass (PBM)
* at or below -2.5 SD is defined as osteoporosis
If your Z score is below -2, your bone density is lower than it should be for someone of your age.
Although BMD results provide a good indication of bone strength, the results of a bone density scan will not necessarily predict whether you'll get a fracture.
For example, someone with low bone density may never break a bone, whereas someone with average bone density may have several fractures.
This is because other factors, such as age, sex or whether you have previously had a fall, also determine if you're likely to sustain a fracture.
The femoral neck is a bit low - but you could well improve that in the same way HeronNS did. The femoral neck is the place you get the hip fracture they are always concerned about.
And - sorry, another question - does this kind of DEXA result look like what you'd expect from 18 months on Prednisolone? ( I started at 15mg and got down to 7-8 quite readily, then see-sawed a bit.) Or is it impossible to tell? It's not unheard of for a 65 year old woman to have osteopaenia.
Virtually ALL of us will have osteopenia even without pred. It isn't a pathological condition, it just a word meaning your bone density is lower than it was on average in your 30s. My first dexascan was done 3 months into pred and the t-scores were -1,3 or thereabouts, After some 12 years on pred, my worse score was -1,6.
Our peak bone density happens about age 30 providing you have had a decent diet and lifestyle. From then on it usually falls slightly and then after the menopause the deterioration is faster for most. Pred speeds up the deterioration for some - not all. And the bisphosphonates were developed and then marketed wiith an awful lot of hype and product placement which convinced doctors at a critical part of their education that they are a wonder drug. They have a role - but they do not always work. I knew a lady in her 80s who was still playing tennis until she developed spinal fractures. She had been taking a bisphosphonate for years as well as her obviously active lifestyle. She wasn't amused as you can imagine and said so to her doctor - then why did I take those tablets all those years? Was a waste of time said the doctor! She had kyphoplasty - and went back to playing tennis.
Thank you. Ah. I will have a long 2nd look at HeronNS's post. Well I don't know anything about osteoarthritis; I've talked to my GP long ago about arthritis in my hip - Doc says until paracetamol won't deal with the pain and I can't walk I won't even get an X-ray. I'm nowhere near that. I have what I understand is arthritis in one my big toes - the knuckle bone is all grown over with bone and does not bend any more. So my readings might be sort of false positive and something to ask the Doc next time?
Glad that isn't MY doctor. What an appalling attitude. There can be patients with little or no pain who are walking bone on bone and ones with no sign of anything but are in agony. I am very unimpressed with some GP's attitudes - surgeons like to get you long before you can't walk as then the result is far better.
yes I thought it was odd, just waiting for the worst case. Toe and hip. I'll start bringing it up again. Thank you. So osteo-arthritis is the main arthritis, which is what I have at least a bit of, and because of that the bone densities may not be as good as they appear in the report? What a disappointment!
I was told 6 years ago, before the current crisis situation, that i shouldn't be considered for hip replacement unless I had pain. I continue fortunately to have no pain.
- so it is not just a backlog due to Covid, it's what has been decided. Do you know for sure that you have an arthritic hip? Mine is stiff and kind of 'gives' when I stand up after being seated for a while.
That actually might be a complex one. On x-ray definitely a ravaged hip. But I had a fall. The fall twisted my leg. The diagnostic x-ray under discussion was immediately after the fall. It's a ball and socket joint and I have wondered to what extent if any the XR showed/also showed damage to the socket ?? capable of some repair of itself when the ball twisted out of position. Mild OA in the other hip. Perfectly happy to believe I have it in the twisted one. The question is how much. Since pain-free, hips are next on the list to be sorted when hopefully PMR minimal or gone.
Whether it's national policy or just my local orthopods, I don't know.
"Heterotopic ossification." I first heard of that after my athletic, vibrant nephew was in a car accident. His muscle turned to bone, and he could not sit. Lying flat was his only option for a long time or standing. The accident was a couple years ago, and I'm pleased to learn he has come a long way and seems to be living a more normal life.
My nephew's situation was caused by trauma. It seems the condition is not common, or we would hear more about it. Yet, you describe evidence it is a "common complication of surgery." Who knew?
How unlucky to get this condition after knee surgery, when one is looking forward to less pain. Your acceptance of not having surgery seems like a healthy outlook.
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Dexa Scan
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