Do I need a DEXA scan, or not?

Megrose489
Megrose489 Member Posts: 776
edited 22. Jun 2014, 13:24 in Living with Arthritis archive
Can I ask your advice, please? It's not strictly speaking about my OA, so I hope that's all right.
I found out that my Vitamin D levels were 22.2 nmol/litre - see my earlier post - which is very low. Deficient, in fact. I don't know how long I have been this low and now am beginning to worry about my overall bone health. I saw my GP last week and asked for a fracture risk assessment, principally because of my low Vitamin D results and also because my mother fractured her wrist when she was 65. This was in 1973 and her bone health was never investigated. The FRAXX assessment tool only asks about parental hip fractures, however. The result was that I was low risk and so he said I was fine and didn't need a DEXA scan. However, I realised later that he had put in the wrong weight - I've lost weight in the past year - and when I repeated the calculation - the FRAXX assessment tool is online - I found I was actually borderline between low and medium risk. It is only when you're at medium risk that a DEXA scan is suggested. It also says that the calculation is a guideline and whether to refer for a scan or not is up to the clinician.
I don't know whether to push for a DEXA scan again when I see him next week, for a steroid injection for bursitis, or just keep taking the Vitamin D tablets and forget about it. I don't want to be thought a pest, but at the same time, don't want to, perhaps, have a problem which isn't being addressed.
I will be seeing my gastroenterologist in a few weeks, so wondered whether to discuss it all with him instead. I could print out the FRAXX reading? He's the one who picked up on the low Vitamin D levels and gave me the prescription for the Colecalciferol.
Am I worrying too much about this? I'd really appreciate your thoughts. Thanks.

Meg

Comments

  • stickywicket
    stickywicket Member Posts: 27,697
    edited 30. Nov -1, 00:00
    I don't think worry is good, Meg, but maybe you're right to be a bit concerned.

    It is hips that they concentrate on then backs, I guess because these are the danger areas. In my case they couldn't scan the hips or lower back (THRs) so they also did an arm.

    I think I'm right in saying that OA doesn't predispose you to osteoporosis in the way that RA does. (Though steroids do.)

    You are only, at best (worst?) borderline so, in your position, I think I'd wait and have a word with the gastro who prescribed the Vit D. I can't see a few more weeks making any difference except, possibly, to your anxiety levels. And, if you get no joy from him, you still have the option of going back to the GP. In the interim, you could check out the National Osteoporosis Society's Advice on building healthy bones http://www.nos.org.uk/page.aspx?pid=248
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • elnafinn
    elnafinn Member Posts: 7,412
    edited 30. Nov -1, 00:00
    Hi Megrose

    I have no idea of your age but if you are 50 or over you could do the quick and easy bone check to see if you are at risk:

    http://stopatone.nos.org.uk/

    Nothing is suddenly going to happen overnight. You can wait until you see your gastro to discuss matters further. It is good that your Vit D levels were tested.

    You can also call the NOS Helpline on 0845 450 0230 or 01761 472721
    The service is provided by nurses with specialist knowledge of osteoporosis and bone health. They can provide you with a personal reply backed up by information provided in electronic or printed format.

    Elna
    The happiest people don't have the best of everything. They just make the best of everything.

    If you can lay down at night knowing in your heart that you made someone's day just a little bit better, you know you had a good day.
  • Megrose489
    Megrose489 Member Posts: 776
    edited 30. Nov -1, 00:00
    Thank you both for your really helpful replies.
    I'm 68, Elna, and the bone check I've just done - thanks for the link - pointed up a couple of things I could mention to the gastroenterologist.
    And I will wait and speak to the gastro, Sticky, thank you for suggesting that.

    Meg
  • hileena111
    hileena111 Member Posts: 7,099
    edited 30. Nov -1, 00:00
    Hi Meg
    I'm still waiting for the results of my DEXA.....they said it would go to my GP in 6 weeks....its well past that an the GP says they are taking 3 months now??
    Sorry that's not what you asked......you are on meds anyway so waiting a little while before asking wont do any harm
    Good luck with it and the results.
    Let us know
    Love
    Hileena
  • daffy2
    daffy2 Member Posts: 1,636
    edited 30. Nov -1, 00:00
    Meg, I'm interested that you say you were able to use the FRAXX assessment, because I thought that needed the results from a DEXA scan to do the calculation? My GP did it for me and came up with a pretty unpleasant result, but we agreed that it didn't help much as the tool is only designed(so far) to deal with hip fracture risk, and my problem is lumbar spine.
    As the others have said it would be worth doing some info collection from NOS, and raising the matter at your gastro appointment - not least because if he considers a DEXA scan to be appropriate there is possibly a better chance of it happening if he orders it than your GP - but in the OP scheme of things a few weeks wait for that appointment won't make that much difference.
  • Megrose489
    Megrose489 Member Posts: 776
    edited 30. Nov -1, 00:00
    Thanks Hileena and Daffy. The FRAX assessment will still calculate, even if you don't put in the DEXA scan result, Daffy. However, it's probably not as accurate a reading. (Sorry, should have been one X, not two!)

    http://www.shef.ac.uk/FRAX/tool.aspx?country=1

    I've started looking at the NOS site, which has a lot of useful information, and will definitely discuss it all with the gastro when I see him.

    Meg
  • barbara12
    barbara12 Member Posts: 21,280
    edited 30. Nov -1, 00:00
    Hello Meg, sorry Im late seeing this, it seems the others have given you lots of advice and links..I have asked about a dextra scan but I think they have forgotten me...I haven't broke anything but I think my late mum might have had OP she lost height quite rapid and had a couple of fractures..I do hope you get one soon and they can hopefully put your mind at rest..xx
    Love
    Barbara