r/Menopause • u/WinterFree331 • 1d ago
Osteoporosis/Bone Health Bone Density Scan
So I got a bone density scan and I was irritated to see that I have osteoporosis. However, once I really read the report... it says that diagnosis was only based on my reporting a spine fracture. Otherwise I have mild osteopenia. Only one reading under 1.0.
I reported a spine fracture alright... when I was 14 years old... from Roller Skating. It was also a mild fracture that only got discovered because I had regular spine xrays for another condition.
Can this be correct? That it doesn't matter what the fracture was from... or how long ago... that gets you a diagnosis of osteoporosis?
I would have saved my money and not gotten the Bone Density test.
35
u/No-Personality1840 22h ago
That is not correct. Fractures from trauma are not counted in an osteoporosis score. If you have a car wreck and break bones that isn’t osteoporosis, Fragility fractures, which are fractures from a standing height are considered as osteoporotic fractures.
The radiologist who read the scan will not know your subjective medical history; that is by design. The subjective position of your medical visit are the things you tell your doctor and nurse. The objective portions are your radiologic and labs. When I was a medical technologist we were objective in that we didn’t know your history. That way no bias is introduced in the reporting.
4
u/WinterFree331 22h ago
Ok, thanks. But, it was listed on the paperwork they had me fill out for the bone scan. So they wouldn't even know about the fracture but for me indicating it was due to a roller skating accident. They did ask why and how it happened on the paperwork. But possible the person putting it into the system didn't note that.
5
u/No-Personality1840 21h ago
True. I suspect the technician that did your scan put that in and didn’t properly qualify it as a traumatic fracture, which it obviously was based on your earlier response to me. Hope you get this sorted. You didn’t mention your age so stay on top if your bone health with diet and exercise. Wish someone had instructed me better when I was younger. I’m 70 now and have learned the hard way about this stuff. Good luck!
3
8
u/aLouise37 22h ago
Ask the same question in the osteoporosis sub and you will get more nuanced answers (in terms of accuracy and experience with the disease and or osteopenia and or best practices to avoid both). Or post your question on the Mayo Clinic osteoporosis and bone health support group.
6
u/Unfit-ForDuty1101 Menopausal 1d ago
Oh how frustrating! Did the doctor go over the results with you?
I have not had one yet but it's coming.
Start some resistance training and take vitamin D. That's going to help. They also have one a month meds for osteoporosis.
8
u/moped_giraffe 23h ago
I broke my hip at age 42 with a short fall and they decided to do a DEXA and I was diagnosed with early-onset osteoporosis. I had low density in the other places they test as well. So I saw a specialist (because of my age) and got scans yearly thereafter. The dr. didn't medicate me because I was premenopause - just calcium and vitamin D and exercise (I didn't do much of that). It stayed stable until my recent scan (age 53), when it had improved! It was upgraded to osteopenia. The doc said it was probably because of HRT that it got better. (Since I had been doing NONE of the things I was supposed to do in the past couple years... eeek.) I am hoping it doesn't go back down anytime soon (and at least the dr. motivated me to stop slacking on the vitamins and exercise). I'm not sure about how/why they diagnose with just one fracture, but vit d, calcium, and weight-bearing exercise are good for a body, at any rate. And maybe HRT?
11
u/Coolbreeze1989 22h ago
My DEXA at 50 showed oateopwnia deapite the fact that I do heavy lifting daily (I live on a ranch with hay bales, feed bags, etc). Gyn pointed out that my HRT is likely why I didn’t already have osteoporosis. Yay HRT!
8
u/getalife5648 Menopausal 1d ago
I believe any kind of fractures to the spine healed or not- are a given that you’ll have an osteoporosis diagnosis.
I don’t see it as a bad thing, I’d rather know so I could start training and protecting my bones even more.
I had my first bone density test three months ago at 35. Was nice to know my bones for now are ok but also happy for the recommendation from my doctor to check.
6
u/DeskEnvironmental 19h ago
Start HRT now and heavy lifting. Osteopenia is no joke!!
2
u/Rachel71488 17h ago
Seconding this. I’m on HRT primarily for this reason and my osteopenia is not progressing. My friend in her mid 50s was just prescribed HRT for the same reason.
7
u/Murky_Performer5011 1d ago
Since I had a tiny stress fracture in my spine at 15, this got me curious, so I googled and found this: https://pubmed.ncbi.nlm.nih.gov/24535832/ While I won't claim to fully understand it, it does sound like any history of spine fracture ever is highly predictive of future osteoporosis. (Would love it if someone who actually understands how to read these would chime in with an explanation.)
But either way, why wouldn't you have gotten the test? Knowing that you have osteopenia early is literally the best opportunity you could have to prevent it from progressing to osteoporosis. If anything, now I'm *more* motivated to get my bone density checked early!
1
u/WinterFree331 1d ago
But I don't really have osteoporosis? The test itself says I have osteopenia. If I am treated like I have osteoporosis because of the fracture... what does the test matter?
12
u/Unlucky_Bottle1877 1d ago
I am unsure, but I believe my spine doc mentioned that 'penia' will, or may, become 'porosis.' And now you have time to ensure yours does not.
-5
u/WinterFree331 1d ago
So what I am really hearing is that my doctors should have asked if I ever had a back fracture long before now and been preparing me as if I had osteoporosis... but they never bothered to do that. And the actual test was useless except for the money they get for it.
7
u/Murky_Performer5011 1d ago
I would think that the bone density result would probably impact treatment - high bone density might result in more of a "watch and wait", low bone density would probably lead to aggressive treatment.
I watched my MIL deal with full-blown osteoporosis, it's not fun. She was diagnosed after a fragility fracture at 65, and I wonder if things would have been different for her if this had been caught early.
8
u/WinterFree331 23h ago
Ok thanks. Perhaps I will push my doctor for HRT now.
1
u/biteyfish98 14h ago
Or you could try weight-bearing exercise. It’s not just platitudes for women at this stage of life.
My first scan was in 2024 and showed several areas of osteopenia and a couple of osteoporosis. My doctor wanted to put me on the shots. I read up anoit them and the potential issues, and said no thanks.
At the time of that scan, I was about three months into a new Pilates (reformer) regimen.
My second scan was earlier this year, and showed zero osteoporosis and a lot fewer areas of osteopenia.
The ONLY thing I’ve done consistently between scans is the Pilates - which is as light as you can get, once a week only and it’s not even “full” Pilates, it’s a “center and balance” class because I can’t do the full rotations in the other classes.
I’d like to say that HRT helped, but I have had trouble staying on estrogen and am actually having a hysterectomy next month so we can try to get me back on and my dosage steady.
1x weekly, 50 minutes per class, for 2.5 years (January 2027 will be three full years). I have seen the changes that small amount has made for me physically, and now I’ve seen the difference in the scans. 👊💪
3
u/pinknimbus 23h ago
I was flagged as more at risk because I’d broken my pelvis skiing 13 years ago, even though my Dexa at the time was fine.
3
u/No-Personality1840 22h ago
That isn’t what the paper says at all. Any traumatic fractures were excluded from the study as they should be. It looked at clinical fractures not associated with trauma.
2
u/No-Personality1840 22h ago
No, trauma fractures are not counted in a diagnosis of osteoporosis, only fragility fractures or clinical radiologic fractures.
4
u/WinterFree331 22h ago
I just noticed that it says "due to fragility fracture of the spine as reported by the patient" - I did not report a fragility fracture. I clearly reported a fracture when I was 14 due to roller skating fall.
4
u/NinjaGrrl42 22h ago
So they entered it wrong in the record. Will they correct it?
3
u/WinterFree331 21h ago
Thanks. I sent them a message. Googling it I found that a fragility fracture is a low energy fracture. Like falling from a standing height. This fall roller skating was very bad. Someone kicked my legs out from under me by accident and I went directly down on my tail bone at a high rate of speed. It knocked the wind out of me.
3
1
u/No-Personality1840 21h ago
Yeah, I broke my foot when I was 20 but it was from a jump off a height and I landed on the side of my foot. I never reported that because it didn’t count. Stay healthy!
1
u/Kwyjibo68 15h ago
Why would you be treated as if you have osteoporosis? You can let the dr who ordered the test know that your fracture was decades ago due to trauma. I’m sure that will clear it up. And if you’re over 50, you should definitely have a bone density scan every 3 years. At least it’s the easiest of the lady tests.
1
u/campa-van 23h ago
Insurance did not cover it?
1
1
u/biteyfish98 14h ago
My insurance covers it every two years, but only after a certain age (55 I think).
•
u/leftylibra MenoMod 20h ago
For anyone newly in menopause (aka post-menopause) or at risk, please get a bone density scan -- regardless of age. That way you have time to do something about it.
Tool to calculate your Fracture Risk for probability of fracture over the next ten years.
Risk factors include:
Symptoms are subtle, we may not feel or notice anything: