Dexa scan results confusion

[jaycee444]

Results of Dexa scan lumber region not hips because of 2 replacements. T scores come in as L1 =1.9 and L2 = 0.1 All the rest come in between -0.2 and -0.8 Have had a message to say make appointment to see GP re Osteoporosis. Are these results I should be really worried about? Apart from the first two the rest dont seem to me to be terribly high . Am I mistaken? I am confused. I do not want to take Bisphosphonates un less absolutely neccessary. Am currently on 4mg Prednisolone.

[DorsetLady PMRGCAuk volunteer]

I’d be bit confused as well -these are WHOs figures - was message from surgery or part of the DEXA scan report?

A T-score equal to or above -1.0 is considered normal bone density.

A T-score between -1.0 and -2.5 is considered low bone density, sometimes referred to as osteopenia.

A T-score -2.5 or below is considered osteoporosis.

[jaycee444 in reply to DorsetLady]

Message was text from my GP at surgery . I looked at my results online and couldn’t quite interpret them at first but after a bit of research came to the conclusion that they are not disastrous? Wondered why I have to make an appointment to see him regarding these results and have come to the conclusion that he will want to put me on Bisphosphonates. Have refused them up to now even though I have been advised to take them. I dont want to take them unless I absolutely have to.

[DorsetLady PMRGCAuk volunteer in reply to jaycee444]

They look fine.. so not sure why GP needs to see you, unless as piglette and you say, they are pushing bisphosphonates.. but that’s your choice . Are you on prescribed VitD/Calcium supplements? If so, seems as if they are doing the job..

[jaycee444 in reply to DorsetLady]

Take Calcium Citrate 500mg per day + Vitamin K2 + Vitamin D3 1000mg per day

[DorsetLady PMRGCAuk volunteer in reply to jaycee444]

If you purchase those yourself, GP might not realise… and really should be prescribed.

[jaycee444 in reply to DorsetLady]

Dorset Lady - just noticed a second page on the results. They scanned my wrist (radius) and that had T score of -2.8. So I imagine this is what he is wanting to see me about 🫤. Does this mean I should be taking Bisphosphonates? My spinal results seem ok

[PMRpro Ambassador in reply to jaycee444]

I've explained below why those spinal results may not be reliable. The radius reading is probably far more representative - and if you were to fall onto that hand, you would be at increased risk of a wrist fracture.

[DorsetLady PMRGCAuk volunteer in reply to jaycee444]

You may be right on that -don’t often see wrist scores. Maybe contact ROS before speaking to GP

theros.org.uk

[PMRpro Ambassador in reply to DorsetLady]

bmcmusculoskeletdisord.biom...

ncbi.nlm.nih.gov/pmc/articl...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Thanks-interesting.

[piglette]

The results seem fine to me, perhaps there is something they have left out?? If they are like my GP he wanted me on bisphosphonates every time I phoned him and my results were all positive.

[PMRpro Ambassador]

The other figures are probably skewed and look in normal range BECAUSE you have osteoarthritis and boney changes increase the readings because of the structure of that bone,

The lumbar readings are osteopenia not osteoporosis but they are fairly low and heading for osteoporosis. However, if you had been following tangocharlie 's posts you would have heard that both she and I have good dexascan results if you go by the numbers, both of us had better readings than yours, but she has had 4 compression fractures of the spine and I probably have had one. Since I had an infusion of zolendronic acid in February the excruciating back spasms I have had for well over 2 years have settled down. There was no sign of any fracture 2 1/2 years ago but there was last Christmas and the most common cause of severe back muscle spasm is a spinal fracture. They don't always show up on a plain x-ray.

The dexascan results are not gospel - and my rheumy here commented "it isn't the density, it is the quality of the bone",

[tangocharlie]

Those measurements seem fine to me. But I've learned the hard way that DEXA scans are not a reliable indicator of osteoporosis anyway and you have to look at the package of risks includiing age, on steroids, previous fractures etc etc to make a decision. Maybe they think because you've had hip replacements your bones are fragile but that's a different cause presumably to osteoporosis? I don't know. I'd ring the ROS nurses and see what they say then armed with that info go and have a chat with the GP

[jaycee444 in reply to tangocharlie]

Just noticed a second page on the results. They scanned my wrist (radius) and that had T score of -2.8. So I imagine this is what he is wanting to see me about 🫤. Does this mean I should be taking Bisphosphonates? My spinal results seem ok

[tangocharlie in reply to jaycee444]

Dunno I'm afraid, best ask the experts eg the nurses on the ROS Helpline

[PMRpro Ambassador in reply to jaycee444]

I would say you really do need to consider it. As I did, I always said if I was shown I needed one, I would take it. The compression fracture was enough evidence for me and I'm now on a course of 3 annual infusions. The back pain is far better - would I never have had it if I had taken a bisphosphonate sooner? No way of knowing but ...

[jaycee444 in reply to PMRpro]

Thanks PMRpro. If I have to have a Bisphosphonate I would prefer an infusion. Have enough to take orally one way and another and have Ulcerative Colitis too so reluctant to add more to the mix .

[PMRpro Ambassador in reply to jaycee444]

Now you have seen all your results, I would call the ROS helpline and talk it through.

[AgedCrone]

Believe me..if you have to continue taking Prednisolone do discuss things with your GP.

I had no symptoms of osteoporosis & I never took Pred ….had a fall & fractured two vertebrae…turned out despite regular Dexa scans I had developed osteoporosis…that was 4 years ago & I am still in pain.

Do call the Royal Osteoporosis Society….. they have specially trained nurses who will talk you through all the different types of biphosphonate and other methods of treating osteopenia and osteoporosis, and seem to have much more time than GPs or other consultants one may see, to give you personal advice..