Does anyone know "lots" about Dexa bone scans?

[KatyMac]

I've had a surprising result! For the first time ever I am healthier than anyone thought!!

I had a heel scan on 2016 with a T score of -1.6 & -1.7 I know heel scans are very accurate but I thought it was a ball park figure (concerning so I did a bit of yoga, Ballroom dancing and bike riding for about a year then had to stop as I got ill again)

Yesterday my hips were 1.4 & 1.7 and my spine was 3!!!

If I understand correctly Tscores are deviations from a mean for a young adult so this is pretty odd

Or I got someone else's results! I really was not expecting positive numbers

Bump

Yes I do having had them for 15 years and I've given you loads of info!

All T scores are based on a 30 yr old adult.

Your Z score is the equivalent of the T score but for a woman the same age, so that ought to be on the print out.

You should also have had a scan of 3 areas of your hips, not just the femoral neck, but also the other areas and they take an average of the total to give your T and Z scores.

Bike riding will not help bones as it's not weight bearing.

You need to wait and see what the consultant feeds back to your GP.

A radiographer just does the scan. They are not qualified to give an opinion or a diagnosis- that is done by the consultant.

You can find out loads online as well if you google. :)

Queen - I am taking on board what you have said - I honestly thought 3 was good but I listened to you who said it was unusual.

I was hoping to hook a radiographer with this thread to give me a hint/clue what is happening as it could be (a) week/s before I get my report

My brother (a biochemist/with a fair amount of bone info) is busy researching away using some of the info you gave me - I also found a radiography wiki which threw up some interesting differencial diagnosies for high T scores

But to be fair MN is often the easiest place to get 'good' info on a topic you know little about

t score explantion

Hope this helps.

The NHS site has loads on T scores on their website.

Heel scans are not accurate but it's unusual to say the least that your score has gone from minus 1.7 to PLUS 1.7 (an increase of over 3) in a short time if you have not done anything to improve things, like weights etc.

I know of one person (elderly) who did have a heel scan that showed osteo, and when she had the DEXA scan it confirmed it.

If you are worried, you ought to call the Nuffield and talk to the radiography dept you did pay for it, and although they will pass it on to a consultant, they may also be able to tell you by phone why your heel scan score and this new one are so different.

I'm slightly surprised the Nuffield are including a consultant's opinion for the price you paid- all mine were done privately and they were then passed to my consultant you requested them (I had to have a referral form for the hospitals) and I follow up that way.

Thanks Petalflowers - I am waiting to talk to a nurse on thier helpline

Queen, I'd rather ring the hospital back when I have an idea what I am concerned about other than a vague "that's odd"

If it's unusual for a T score to move from -1.6/7 to a positve 1.4/7 then I'd like to know that as a fact - to me it seems a huge change but is it rare? unusual? or 'one of those things'?

I will speak to the hospital but Osteosclerosis is increased bone density and can be due to oestoarthritis

I have oestoarthritis in both my hips and my lower spine so this might be an easy 'cause'

I'll let you know when I have spoken to them

The questions you want answered are is the heel scan accurate and if so what explanation is there for such an increase in 2 years.

The rate of bone loss for women around you age is usually 1% a year.
That means that without doing anything different your scan from 2 years ago should have decreased.

To go from -1.7 to +1.7 is a good increase. You've gone from -1.7 to 0.0 and up again to a positive score of +1.7

This is unusual as we all lose bone every year. Post menopause the rate can be 5% in a year (so in 5 yrs a woman can lost 25% of bone.)

Osteoarthritis is when the bone and the joints wear out- so there is pain around the joint due to lack of lubrication between the joints.

I think you are over-thinking this to be honest. You will get the results from whoever reads your scan and writes to your GP (presumably.)

The nurse at the NOS won't be able to tell you much without reading your scans, having an in depth chat about lifestyle etc as she wont know what you may have done or not done to improve your bones.

Just to add- I have improved my bone density over many years from almost having full osteoporosis in my late 40s, to having very mild osteopenia in my hips. But I have really worked at it, with a personal trainer showing me exercises, working out 3 x a week, walking around 12 miles a week over hills, and taking calcium and Vit D, and HRT.

The nurse said 3 is unusual but not rare

The difference between heel and hip could be joint based (my heels are bad, my hip is good) or it could be due to oestoarthritis - which based on my history is likely

She 'thinks' when the GP gets my report from the hospital she will refer me to get some other joints/bones checked and make a decision based on that

I don;t think a year of cycling on an electric bike, 6 months of once a week yoga and 4/5 months of ballroom dancing really compares

GP sent me for an Xray - she also thought it might be oestoarthritis in my hips/lower spine - if it isn't she will refer me to a specialist

according to this iwww.hopkinsarthritis.org/ask-the-expert/bone-density-scanning-and-osteoarthritis/ it is only very advanced osteoarthritis that affects a Dexa scan. Presumably you don't have that or you'd not be able to dance, do yoga and ride a bike.

The radiologist- if they assess your scan- would be easily able to tell- the bones would look very different.

www.hopkinsarthritis.org/ask-the-expert/bone-density-scanning-and-osteoarthritis/

Thanks - i'll let you know what they say - I may not get the results tomorrow tho'

Hey from my understanding DEXA scans are the definitive diagnostic test for osteoporosis and the heel test can be used but not as accurate. DEXA and osteoporosis's treatment/management all weights up the risk of fractures vs risk of treatment. With any diagnostic test there are limitations to this test such as osteoarthritis as the most common one. However it is used in conjunction with clinical judgement. A person with a T score of 2 but has had fractures may need more investigation however someone with a -2.5 with no fractures may not necessarily be put on treatment depending on other determining risk factors.
I think in yr case as someone said before you may be over thinking things. I would wait for the official report and xray results as it may be arthritis giving you a better result that yr bones actually are but u seem to have a great attitude towards it and know the right things to do. The national osteoporosis society are fab for info and they have a helpline they may not be able to discuss yr scan (there seems to be a difference with scans regionally) but they have a great leaflet about arthritis and osteoporosis you should look it up. Sorry don't think I have told you anything you didn't know but please try not to worry to much about it!

Different machines will have different calibrations so one result from one machine can be different to another. One test gives one result but what really matters is to monitor any progression...using the same machine. Of course dexa machines only last about 10-15 years so can't always follow up on the same ones.

The newer machines give a detailed analysis with the results and all the consultant does is check there are no anomalies and tick the box. Older machines only give the result and the consultant will need to spend more time to analysis what it means for the patient.

This is why with the newest machines, the radiographer can sometimes 'read' the analysis but indeed, ultimately it can only be ratified by a consultant.

Thanks motherone - the Dexa was to inform my decision about HRT as I'm in surgical menopause at 50

swingofthings i think even allowing for callibration/different machines and different joints, a change from -1.7 2 years ago to +1.7 2 days ago needs some thought

what's the state of play with this now katy?

As you had the scan done privately, the follow up can vary in my experience.

The minimum you'd get would be your copy of it.

The next option is a copy to your GP (especially if they referred you.)

The final option is the scan to be commented on either by a doctor - a radiologist (NOT a radiographer- the person who does it) OR a consultant.

This last one- you'be expecting that to be a paid-for service as it' s not usually included in the scan (unless it's been done at the request of a consultant in the first place.)

You said your GP has sent you for X rays for arthritis. Is this as a result of the DEXA scan (which they have now seen) OR because you have had symptoms for some time that might be showing you have arthritis of the spine or your hips?

I have had bad hips/spine for most of my life I had bilateral hip displasia as a baby - during my childhood and teens my hips popped in and out of position occasionally fully dislocation (usually going down stairs).

This led to me walking 'badly' and lots of lower back pain as well as hip pain more significantly in my left hip to the point that I only drove a geared car for my text then moved to automatic almost stroight after.

The back/hip pain has continued most of my life - but with CFS & FM as well as hypermobility, chronic pain just "is" if you know what I mean - the left hip sometimes gets 'set' the right almost never and my back is a disaster zone - but we "don't talk about it" as it just "is"

I was told in my early 20s to get on with it, so I have

Xray this morning, results should be by Friday
Report from Monday's Dexa scan expected at both GPs and through the post (self referred but they asked if I wanted them to send to the GP)

GP saw the paperwork I had and immediatley started asking about hip/back pain and mobility, we worked out I hadn't had a hip Xray for over 20 years so we booked one.

We have put HRT on hold while we investigate this - although she had her book out with pages marked when I arrived

Referral arrived this morning for bowel/bladder clinic

I cannot beleive how proactive this GP is it makes such a change from my old practise - there I had to do every bot of research and demand treatment/referrals (often taking months/years) here I mention something and the question is "when was it last checked" more than 2 years ago? "Better see someone things have changed since then" it's astounding!

She says she will refer me to a CFS/ME/FM clinic when all this stuff has died down and I am stabilised - I was totally in shock!

I have spent so many years arguing that 'this new symptom' (whatever it was) wasn't just part of my existing conditions and NO it wasn't depression/anxiety - am example I saw the GP at my old practise 4 times before they agreed with the physio I had seen privately that it was tennis elbow - I had been given 2 lots of antidepressents by that time! 6 weeks of exercises and it was sorted

Phone Nuffiled and the Dexa consultant was off last week and he will be in on Tuesday - report to follow

Xray results are 'normal' which is odd in itself as I had the start of oestoarthritis at about 19/20

So current plan is to wait for the report and then see the GP again

As you can see on that diagram using my Z score of 3.3 I am in less than 0.1% of the population!!