Beyond Bone Density

REMS stands for Radiofrequency Echographic Multi-Spectrometry. It is an innovative, non-invasive technology used to assess bone health and measure bone density. Unlike traditional methods, REMS does not use radiation and instead relies on ultrasound technology to provide quick, accurate, and reliable results. This makes REMS a safer and more comfortable option for monitoring bone health, especially for individuals who need regular screenings.

With REMS, you can take a proactive approach to your bone health with cutting-edge technology designed for accuracy and ease.

The key difference between DEXA (Dual-Energy X-ray Absorptiometry) and REMS (Radiofrequency Echographic Multi-Spectrometry) lies in the technology and patient experience:

• Radiation-Free: REMS uses ultrasound technology to assess bone density, eliminating exposure to radiation. In contrast, DEXA relies on X-rays, which involve low levels of radiation.

• Comfort and Convenience: REMS scans are quick, painless, and non-invasive, performed without the need for heavy equipment or uncomfortable positioning.

• Accuracy and Reliability: REMS delivers highly accurate results for bone density and fracture risk, often detecting subtle changes that DEXA may miss.

• Frequent Monitoring: Because REMS is radiation-free, scans can be performed more frequently, allowing for better ongoing monitoring of bone health.

• Bone Density (BMD) refers to the amount of mineral content (such as calcium) within your bones. It is primarily used for diagnosing osteoporosis and osteopenia according to WHO standards. Traditional scans, like DEXA, focus on measuring BMD.

• Bone Quality goes beyond density to evaluate the structural integrity and strength of the bone. It considers factors such as bone microarchitecture, mineral distribution, and overall bone health, which are critical for understanding fracture risk.

While BMD is essential for diagnosis, bone quality provides a more comprehensive view of bone health. REMS technology uniquely assesses both bone density and bone quality, offering a more accurate and holistic evaluation of bone strength and fracture risk.

• T-score: The T-score compares your bone density to that of a healthy young adult of the same sex. It is primarily used to diagnose osteoporosis and osteopenia based on WHO standards:

  • A T-score of -1.0 or above is considered normal.

  • A T-score between -1.0 and -2.5 indicates osteopenia (low bone density).

  • A T-score of -2.5 or lower indicates osteoporosis.

• Z-score: The Z-score compares your bone density to what is expected for someone of your age, sex, and body size. It is especially useful for younger individuals, premenopausal women, and men under 50 to evaluate if bone density is unusually low for their demographic.

• Fragility Score: Unique to REMS technology, the Fragility Score assesses both bone density and bone quality, providing a more accurate evaluation of fracture risk. By combining structural and density data, the Fragility Score gives a clearer picture of bone strength and helps predict the likelihood of future fractures.

Together, these scores offer a detailed understanding of bone health, enabling proactive care and personalized treatment decisions.

1. Several studies have demonstrated that there is good agreement between DXA and REMS scans concerning BMD. Additionally, DEXA proxy tests to assess a bone’s strength, such as Trabecular Bone Score (TBS) and the Fracture Risk Assessment Tool (FRAX) are similar to the REMS specific Fragility Score. It is important to note that REMS Fragility Score is measured independent of BMD whereas TBS and FRAX factor in BMD in generating a patient’s fracture risk.

2. REMS also provides greater reliability in the scores it generates when compared to DEXA. Three key factors that might impact your results on a DEXA scan is your physical positioning, having the scan performed by the same technician, or if you have any conditions secondary to osteoporosis that might impact the results of your test.

With REMS technology, you can safely have scans as often as needed because it is radiation-free. Unlike traditional DEXA scans, which involve X-rays and limit how frequently they can be performed, REMS uses ultrasound technology to assess bone health.

This makes REMS ideal for more frequent monitoring, especially for individuals who:

• Are actively managing osteoporosis or osteopenia.

• Are undergoing treatments to improve bone health.

• Want to track changes in bone density and quality over time.

Your healthcare provider can recommend the best scan frequency based on your individual health goals and needs. With REMS, you can take a proactive and personalized approach to monitoring your bone health.

From start to finish, an REMS appointment typically takes 20-30 minutes. During this time, the technician will complete your scan and review the results.

You’ll receive a detailed PDF copy of your REMS report via email within 24-48 hours. The report will include information about your bone density, bone quality, and fragility score, allowing you to quickly review your results and discuss next steps with your healthcare provider.

With REMS, you’ll have fast, reliable results to help you take immediate action toward better bone health.

REMS received FDA approval in 2018 for the diagnosis and monitoring of osteoporosis. With FDA approval REMS is now recognized by clinicians as an effective tool in the diagnosis of osteoporosis just like DEXA. (FDA Approval Link)

Currently insurance does not cover the REMS scan.

A CPT Code is in the works, however likely 24-36 months away from becoming available for insurance reimbursement. The latest date we received is mid to late 2026.

Several factors can influence the strength and density of your bones:

• Age: As we age, bone density naturally decreases, especially after menopause in women and with advancing age in men.

• Gender: Women are at higher risk for bone loss due to hormonal changes, especially after menopause.

• Nutrition: A diet rich in calcium and vitamin D is essential for bone health. Deficiencies in these nutrients can lead to weaker bones.

• Physical Activity: Weight-bearing exercises, such as osteogenic loading, strength and resistance training, walking, and running, help stimulate bone growth and maintain density.

• Hormones: Hormonal imbalances, such as low estrogen in women or testosterone in men, can negatively affect bone density.

• Medications: Certain medications, like corticosteroids, can lead to bone loss over time.

• Lifestyle Factors: Smoking, excessive alcohol consumption, and a lack of physical activity can all contribute to weaker bones.

• Medical Conditions: Conditions such as osteoporosis, osteopenia, or rheumatoid arthritis can impact bone health.

Maintaining a healthy lifestyle, including proper nutrition and regular physical activity, can help support strong bones throughout life.