Bone Health: Part One of a Two-Part Series

Welcome to the first installment of our two-part series on bone health. This month, we explore recent advancements in assessing bone health, providing insights into the latest technology to assess true bone strength. Join us next month for “The Pillars of Bone Health,” where we’ll discuss effective strategies to promote, maintain and even reverse osteoporosis naturally.

Our bones do more than provide structure and strength; they play a crucial role in overall health and longevity. As we age, maintaining strong bones becomes increasingly important to prevent fractures, maintain mobility, and preserve quality of life. Studies show that osteoporotic fractures can drastically reduce life expectancy, with one in three women and one in five men over the age of 50 experiencing fractures due to osteoporosis. With an aging population, focusing on proactive bone health has never been more essential.

While bone density has traditionally been the primary indicator of bone strength, it’s only part of the picture in assessing fracture risk. Bone density measures the mineral content in bones, but other factors—like bone structure and quality—also play a role in determining overall fracture risk. This is where newer, more holistic assessment methods like REMS (Radiofrequency Echographic Multi-Spectrometry) technology come into play, providing a more comprehensive look at bone health than traditional tests.

For years, Dual-Energy X-ray Absorptiometry (DXA) has been the standard tool for assessing bone density. DXA scans use X-rays to measure density and are widely used to diagnose osteoporosis. However, while DXA remains a most commonly used tool, it has its limitations. DXA is heavily impacted by machine-to-machine variation and certain patient conditions, which negatively impact its accuracy. A study by Messina et al., published in 2012, found that 90 percent of DXA reports contain at least one error, with 22 percent resulting in incorrect diagnosis. Additionally, most DXA exams focus solely on bone density and do not provide insights into bone quality, an essential factor in understanding true fracture risk.

REMS, developed by the European company Echolight, is an innovative technology designed to address some of the limitations of DXA. REMS is an ultrasound technique that uses no X-rays and does not expose the patient to radiation. Unlike DXA, REMS assesses both bone density and bone quality, offering a more complete view of bone health. REMS technology uses ultrasound waves rather than X-rays, making it a radiation-free and noninvasive option for patients. This not only provides a safer alternative, especially for those who need regular testing, but also offers insights that DXA cannot, including an easy-to-understand five-year risk of fracture expressed as a percentage probability.

One of REMS’ significant advantages is its ability to capture structural information about bones. By visualizing bone architecture, REMS can provide insights into bone quality, which DXA lacks. This can be especially beneficial for individuals at high risk of fractures, as REMS technology can detect early signs of deterioration in bone quality. Furthermore, REMS scans are fast, convenient and do not require the bulky equipment associated with DXA.

Despite its success in Europe, REMS is still relatively new in the U.S., partly due to the healthcare system’s reliance on established technologies like DXA. However, bone health experts are beginning to advocate for REMS as a more comprehensive tool for assessing bone health. Dr. Andrew Bush, a board-certified orthopedic surgeon, notes, “REMS provides a unique perspective on bone quality, capturing information that other technologies miss.” With more awareness, REMS technology is gaining traction and showing promise as a new standard in the U.S. market.

REMS technology offers a proactive solution for anyone committed to maintaining strong bones and reducing the risk of osteoporosis. Approved by the Food and Drug Administration for individuals aged 21 and older, REMS is particularly beneficial for those with risk factors such as a family history of osteoporosis, restricted diets, or intensive cardiovascular fitness programs. It’s an excellent tool to establish a bone density baseline, ideally during peak bone density in one’s 30s or for women in their 40s before menopause—a time often associated with accelerated bone loss. REMS empowers individuals to take preventive measures to support lifelong bone health.

REMS technology is now available in Phoenix at Precision Bone Imaging. This is a great opportunity to use expiring health savings account (HSA) funds and end the year with a clear, proactive view of your bone health