My BMD Results from 2007 to 2024

2007 (my first DXA scan; osteoporosis diagnosis)

My T-score at the lumbar spine was -3.0 (-2.0 at L1, -2.7 at L2, -3.4 at L3 and -3.8 at L4).

My T-score at the left hip was -2.2 (-2.8 at neck, -2.0 at troch, -1.9 at inter).

My BMD results in g/cm2 were 0.712 at the spine (L1-L4), 0.53 at the left hip (neck), and 0.670 at the left hip (total).

2009 My second scan was done 07/06/09 after the following treatment: Fosamax 70 mg weekly from 06/18/07 to 12/24/07, two capsules Doctor's Best Strontium Bone Maker daily from 01/21/08 to 07/06/09.

Spine (L1-L4): BMD 0.749, T-Score -2.7

Lt. Hip (neck): BMD 0.563, T-Score -2.6

Lt. Hip (total): BMD 0.739, T-Score -1.7

2013 (4 years from previous scan; scores in osteopenia range)

0.871 g/cm2 at the spine from L1- L4 (T-score -1.6)

0.692 g/cm2 at the left femoral neck (-1.4 T-score),

0.775 g/cm2 at the left total hip (-1.4 T-score).

2016 (BMD scores improved but still in osteopenia range)

Spine: Total BMD of the spine (L1-4) is 0.897 g/cm2, with a T-score of -1.4.

Left Femoral Neck: BMD is 0.729 g/cm2, with a T-score of -1.1.

Left Total Hip: BMD is 0.812 g/cm2, with a T-score of -1.1.

Compared to the prior study (August 21, 2013), there was a 3% increase in BMD of the lumbar spine and a 5% increase in BMD of the left total hip.

January 2019 (Spine, left total hip, right total hip, right femoral neck show normal BMD; left femoral neck in osteopenia range)

Compared to the prior study, there has been 9% increase in spine density, 6% increase in left total hip density, but no change in left femoral neck density.

August 2022 (showed normal BMD at all sites)

November 2024. The 2024 scan included a TBS, which found normal bone microarchitecture! The only value that was slightly worse than my previous scan of 18 August 2022, was my left femoral neck BMD of 0.728 g/cm2 and a T-score of -1.1 (osteopenia) in 2024, compared to left femoral neck BMD of 0.741 g/cm2 and a T-score of -1.0 (normal density) in 2022.

For almost a year and a half (3/5/2023 through 8/17/2024), I reduced my daily dosage of strontium citrate from 682 mg of strontium per day to 341 mg 4X per week and 682 mg 3X per week. I resumed the full dosage on 8/18/2024.

Originally (2007), my worst BMD scores were for my spine. My most recalcitrant area now is my left femoral neck.

Axial DXA 8 January 2019

The report of my axial DXA scan taken on 8 January 2019 appears below. I have been on 2 grams strontium citrate/day for 11 years. I also take a calcium/magnesium tablet (500 mg Ca/250 mg Mg), a multivitamin with 1000 IU vitamin D3, and several other supplements. I get plenty of protein in my diet. I exercise daily.

As you can see, my DXA results were excellent, except for my left femoral neck, which showed no change from the previous scan.

I am happy with my results, although I know the comparison of this year's results to those of 2.5 years ago contains some built-in error because two different brands of DXA machines were used. My 2016 scan was on a Hologic and the 2019 scan was on a GE Lunar Prodigy.

Changing testing sites, and, therefore, machines, was not my choice. I had been getting my scans in the outpatient radiology department of a large hospital medical center, but the provider is now pushing patients into its freestanding imaging centers. I was told my insurance would not pay for a DXA unless it was done at a freestanding center, but my insurance denied that assertion.

The risk factor for secondary osteoporosis mentioned, but not specified, in the report is early menopause.

INDICATION: Postmenopausal. Follow-up of osteopenia on prior DXA.
Patient reports risk factors for secondary osteoporosis.

COMPARISON: 8/4/2016

FINDINGS:

Spine: Total BMD of the spine (L1-4) is 1.108 g/cm2, with a T-score of
-0.7 and a Z-score of 1.0.

Left Femoral Neck: BMD is 0.883 g/cm2, with a T-score of -1.1 and a
Z-score of 0.6.

Left Total Hip: BMD is 0.928 g/cm2, with a T-score of -0.6 and a Z-score
of 0.9.

Right Femoral Neck: BMD is 0.919 g/cm2, with a T-score of -0.9 and a
Z-score of 0.9.

Right Total Hip: BMD is 0.963 g/cm2, with a T-score of -0.4 and a Z-score
of 1.1.

Compared to the prior study, there has been 9% increase in spine density, 6% increase in left total hip density, but no change in left femoral neck density.

FRAX evaluation calculates 10-year probability of fracture:

Major Osteoporotic: 7.8%

Hip: 1.0%

IMPRESSION:

Based on BMD, diagnosis is consistent with osteopenia.

FOLLOWUP: In 2 years is recommended.

My DXA Scan on August 4, 2016

My scores improved, but I am still in the osteopenia range. Therefore, I will keep taking 680 mg strontium per day from strontium citrate, along with my other supplements. Here are my results:

Spine: Total BMD of the spine (L1-4) is 0.897 g/cm2, with a T-score of -1.4.

Left Femoral Neck: BMD is 0.729 g/cm2, with a T-score of -1.1.

Left Total Hip: BMD is 0.812 g/cm2, with a T-score of -1.1.

Compared to the prior study (August 21, 2013), there was a 3% increase in BMD of the lumbar spine and a 5% increase in BMD of the left total hip.

My lumbar spine T-scores have always been worse than my left total hip T-scores.

 

My lumbar spine T-scores went from -3.0 (osteoporosis) in May 2007 to -2.7 (still osteoporosis but better) in July 2009 to -1.6 (osteopenia) in August 2013 to -1.4 (osteopenia) in August 2016.

My DXA Scan Results Look Great After Strontium Citrate

My first DXA scan was in May, 2007 (diagnosed with osteoporosis):

Spine from L1-L4 T-score -3.0

Left hip (total) T-score -2.2

Left femoral neck T-score -2.8

My second DXA scan was in July, 2009 (After 6 months on Fosamax once weekly and 18 months on strontium citrate, 680 mg strontium daily, still at osteoporosis, but scores improved):

Spine (total) T-score -2.7

Left hip (total) T-score -1.7

Left hip (neck) T-score -2.6

My third DXA scan was in August, 2013 (After 5 ½ years on strontium citrate, scan results were at the osteopenia stage; I was probably at the osteopenia stage before this, but I did not have a DXA scan in 2011):

Spine from L1-L4 T-score -1.6

Left hip (total) T-score -1.4

Left hip (neck) T-score -1.4

Osteopenia is defined as T-scores < -1.0 and -2.5.

Use of Computed Tomography for Assessing Bone Mineral Density

Dual x-ray absorptiometry (DXA) is currently the standard for assessing bone mineral density (BMD) and has been correlated with fracture risk and treatment efficacy. DXA includes the posterior elements of the spine, and therefore may be inaccurate or not possible in cases of severe spinal degeneration, scoliosis, or following lumbar surgery. T-score evaluations are somewhat limited in clinical utility, as the majority of patients who sustain fragility fractures are not in the osteoporotic range.

Assessing local bone quality on CT scans with Hounsfield unit (HU) quantification is being used with increasing frequency. Correlations between HU and bone mineral density have been established, and normative data have been defined throughout the spine. Recent investigations have explored the utility of HU values in assessing fracture risk, implant stability, and spinal fusion success. The information provided by a simple HU measurement can alert the treating physician to decreased bone quality, which can be useful in both medically and surgically managing these patients.

The purpose of this paper is to review the reliability and validity of the techniques used to estimate bone health using CT scans with Hounsfield unit (HU) quantification. Such scans can be used to identify patients at risk for osteoporosis, and these values could be used for surgical planning in cases of trauma, degeneration, and deformity. There was good correlation of HU value to DXA for both BMD and T-score.

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