DEXA Scan Outcome

[anniekins1]

I have been treated for GCA on the symptoms I was having. The biopsy was negative but I had been on 60mg of prednisolone daily for just over two weeks before the biopsy was carried out so I wasn’t really surprised. I have been reducing gradually for just over a three years now and all is going well on that side.

I was given three yearly infusions of Zolendronic Acid and had no side effects thank goodness. The rheumatologist ordered a DEXA scan a few months ago and I recently had a call to attend the hospital three days later. I saw a nurse who explained there was no spinal data available on the system, I asked her why, but she didn’t know. The outcome anyway was: T-score femoral neck -2.6 total hip-4.9. She said the Consultant wanted to put me on Denosumab (Prolia).

As there was a lengthy discussion regarding the treatment I didn’t clarify what exactly a total hip measurement is and if this score satisfactory for the area it is covering?

I know many of you have a wealth of knowledge on these things and I would appreciate an explanation as what a total hip measurement is and is -4.9 something to worry about.

Thanks in advance for any advice you can offer.

[DorsetLady PMRGCAuk volunteer]

hi,

Can I suggest you ring the ROS helpline and discuss your situation with one of their nurses [very good] - but maybe have a look at this first-

Your scores do indicate a significant level of osteoporosis

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ROS website-

theros.org.uk

[anniekins1 in reply to DorsetLady]

Thank you Dorset Lady, the information sheet was very informative. I may use the contact number to speak to them as you can only leave a message at our hospital for the rheumatology nurses. Just not sure what total hip actually meant.

[DorsetLady PMRGCAuk volunteer in reply to anniekins1]

In a DEXA scan, the total hip is a measurement of bone mineral density (BMD) that includes the neck, trochanteric, and inter-trochanteric regions of the proximal femur. The total hip is a standard measurement site for diagnosing osteoporosis. It not just the hip joint.

[anniekins1]

Oh, thank you so much. That measurement covers quite a large important area then. I appreciate your help as it is clearer now. I hope the injections do stop the bone decline.🤞🏻

[DorsetLady PMRGCAuk volunteer in reply to anniekins1]

Yes do I, but do contact ROS they will give you lots of info and reassurance.

[PMRpro Ambassador]

This shows the positions the measurements are taken to get the t-scores as DL has quoted, the pictures show which is where.

courses.washington.edu/bone....

To be honest - if it was me, with spinal figures missing and the discordance in these numbers, I would be asking for a repeat dexascan! Something really doesn't look right with that.

A t-score of minus 4.9 is very low, indicating severe osteoporosis, and really quite unusual to see that in the total hip reading.

I agree with DL - call the ROS helpline as they will know far more than any rheumy nurse and probably more than your consultant!!

[anniekins1 in reply to PMRpro]

I have spoken to ROS helpline and the person I spoke to did say it is unusual to have the total hip score so much lower that the femoral neck measurement but it can sometimes occur. As for the spinal data not being available she also said if there are degenerative changes it can make the DEXA too fuzzy to read accurately. I think that may explain the lack of spinal data as a spinal x ray was ordered and I had the results a few days ago which confirms mild scoliosis, spondylitis changes and in depth other findings which I do not understand.🫤 That may explain the lacking data. I am unable to contact the Rheumatology department so may have to leave it until I have the injection next month. Thanks for your advice today, it’s much appreciated.

[PMRpro Ambassador in reply to anniekins1]

It could well account for the missing data - but usually if there is a good reason like that, it is mentioned.

[anniekins1]

I will try to get hold of the rheumatology department again, if I am successful I will ask further questions on both points.