DXA densitometry has been the accepted standard for bone densitometry for over 30 years. It has helped healthcare providers include bone health as part of routine medical care. However, DXA has had limitations including a high error rate, lack of availability in many locations and repeated exposure to ionizing radiation during serial monitoring. It cannot be offered as an onsite service and requires a visit to an imaging center.
REMS densitometry is changing the bone heath landscape. REMS Radiofrequency Echographic Multi Spectrometry) is a newer method of performing standard densitometry which also offers the additional benefit of assessing microstructural properties of bone referred to as bone quality. The REMS bone quality assessment referred to as the Fragility Score provides the most accurate method currently available to assess fracture risk [Paola Pisani, Francesco Conversano, Fragility Score: a REMS-based indicator for the prediction of incident fragility fractures at 5 years, Aging Clinical and Experimental Research volume 35, pages 763–773 (2023]. Because REMS is an ultrasound (pulsed echographic sonography) it is safe and portable!
Healthcare is preventative medicine – it is the core of fracture prevention. Early screening is essential. Many in the bone healthcare field recommend perimenopausal bone densitometric assessment around the age of 50 yo, not 65 yo as is the current recommendation. By 65 yo a woman may have lost 30% of her skeleton and by that time treatment choices are significantly limited. With early bone assessment, a baseline can be established and then routine yearly monitoring would be recommended. This recommendation for bone health monitoring is very much in line with other healthcare monitoring - blood pressure, cholesterol, and diabetes screening.
CCOA and BH@SOS would like you to consider offering a mobile REMS service to your patients. We would like the opportunity to discuss the potential that a bone health program can bring to the medical services that you provide. Too often, bone health gets forgotten in routine medical healthcare and patients only find out when it is too late that their bones are not healthy – by breaking a wrist, hip, vertebral body, pelvis, or shoulder. Or patients may be unnecessary prescribed medication based only on a BMD value without any reference to their bone quality measure which is the best measure of fracture risk.
