Understand Your Bone Risk
Bone Quality is a key determinant of fracture risk!
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70% of hip fractures occur in individuals without osteoporosis
ECHOLIGHT REMS - Choose the latest in technology!
Echolight® REMS (Radiofrequency Echographic Multi Spectrometry) is an innovative bone health monitoring technology that uses ultrasound-based scanning.This technology is revolutionizing the way bone health specialists assess and monitor not only bone density, but now also can assess bone quality for more complete bone health insight. ​​We are proud to be the 1st location in Montana to offer Echolight® REMS and the 37th in the United States.
What is an Echolight® REMS Bone Scan?
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Non-Invasive & Radiation Free: a safer alternative for regular bone health monitoring especially for those undergoing radiation treatments
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More Precise, Accurate & Comprehensive: Unlike DXA scans that primarily measure bone mineral density (BMD), Echolight® goes beyond by providing a more precise and holistic assessment of bone health. It not only reports BMD but considers factors such as bone microarchitecture and composition offering a more complete understanding of an individual's bone strength.
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Microarchitecture Assessment: Analyzes trabecular thickness and connectivity, cortical thickness and porosity of bone,5 year Risk of Fracture Assessment: Based on BMD and Fragility Score
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Improved prediction for special populations: Greater accuracy for patients with type II diabetes, osteoarthritis, scoliosis, rheumatoid arthritis or other risk factors.
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Real-Time Imaging: Echolight®'s ability to provide real-time imaging within several minutes allows for instant visualization and analysis of bone properties right in our office.
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Instant reporting: T-score, Z-score, BMD and Fragility ScoreEarly Detection & Monitoring: Improved ability to detect low bone density and osteoporosis, at earlier stages (pregnancy and pre-menopause), even before traditional methods. This can lead to proactive interventions to prevent fractures and other bone-related complications.
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Pre-operative bone assessment: Prior to joint replacement or spine fusion surgery to assist in improved surgical interventions
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Portability: Echolight® is a portable technology, allowing it to be used in various care settings and making it accessible to a wider range of patients.
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Benefits and Advantages of® REMS Technology
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Bone quality refers to the overall health and strength of bones, beyond just their density. While bone density measures how much bone mineral content is in a given volume, bone quality encompasses a broader range of factors that influence bone strength and resilience. These factors include:
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Bone Microarchitecture: The structural arrangement of the bone at a microscopic level. Strong bones have a more organized, dense, and well-distributed microstructure to absorb force and can be measured with REMS.
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Bone Composition: This refers to the balance of minerals (like calcium) and proteins (like collagen) in the bone. An optimal balance contributes to bone flexibility and strength.
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Bone Turnover: The rate at which old bone is replaced with new bone. Healthy bone turnover helps maintain bone strength and quality, while excessive or insufficient turnover can lead to weakened bones. See Bone Turnover marker information below.*​​​​
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Material Properties: The mechanical properties of the bone material itself, including its stiffness and elasticity, which affect how well it can resist forces and prevent fractures.
In essence, bone quality is a more comprehensive measure of bone strength than just density and is crucial for understanding bone health, particularly in conditions like osteoporosis.
*Bone Turnover Markers: Learn about what bone marketers you can test for to validate bone production
Why is Bone Quality Important?
What does Echolight® REMS Measure?
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Bone mineral density (BMD): This is an actual measurement of the density of the bone (measured in gr/cm2). The BMD is used to determine the T-Score and the Z-Score. A correct osteoporosis diagnosis is entirely dependent on accurate BMD data.
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T-score: This is a numeric value derived through statistical calculations that directly compares an individual’s BMD to the mean BMD value of a very large database of healthy 30 year-old. A T-score value with a standard deviation of -2.5 from the mean value establishes a diagnosis of osteoporosis.
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Z-score: This is a numeric value derived in a similar manner as the T-Score, but instead, it compares your BMD to the BMD of people your own age and gender.
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Fragility score: This is a numeric value calculated from scan data of microarchitecture, which is then compared to a diverse database of individuals with and without fractures. Unique to Echolight® technology, this score provides a more personalized assessment of fracture risk than DEXA scans, helping to tailor preventive measures and appropriate treatments based on individual bone characteristics providing a 5 year fracture Risk Score. This risk percentage reflects bone quality and BMD, estimating the likelihood of sustaining a fragility fracture within five years vs the traditional 10 years.
How does Echolight® REMS Work?
Understanding the REMS Report
Research Studies
Radiofrequency Echographic Multi Spectrometry (R.E.M.S.): New Frontiers for Ultrasound Use in the Assessment of Bone Status—A Current Picture
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A review evaluating the data on the REMS technique present in current literature.
Short-Term Precision and Repeatability of Radiofrequency Echographic Multi Spectrometry (REMS) on Lumbar Spine and Proximal Femur: An In Vivo Study
Determined the short-term intra-operator precision and inter-operator repeatability of REMS
Fragility Score: a REMS‑based indicator for the prediction of incident fragility fractures at 5 years
FS displayed a superior performance in fracture prediction, representing a valuable diagnostic tool to accurately detect a short-term fracture risk.
Radiofrequency echographic multi spectrometry (REMS) in the diagnosis and management of osteoporosis: state of the art
Overview of REMS technology and current evidence base that supports the technology as a useful tool in the management of osteoporosis as an alternative to DXA.
Radiofrequency Echographic Multi Spectrometry (REMS) for the diagnosis of osteoporosis in a European multicenter clinical context.
Assesses the diagnostic accuracy of REMS with respect to DXA in a wider European clinical context.. Confirms diagnostic effectiveness of REMS technology at reference anatomical sites for the assessment of osteoporosis with femoral neck sensitivity of 90.4% and specificity of 95.5%. For lumbar spine scans, a sensitivity of 90.9% and a specificity of 95.1% were obtained.
Prevalence and type of errors in dual-energy
x-ray absorptiometry
Outlines errors found in DXA Scans.
Preparing for Your Bone Scan
Below are instructions for preparation and additional information for your scan. Please read carefully and email us with any questions. We look forward to meeting you.
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Please arrive 10 minutes early for your appointment time. The schedule is tight and accommodation for late arrivals is not guaranteed.
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Empty your bladder or bowels before being called to the exam room. Arriving 10 minutes early will give you plenty of time to address bathroom calls.
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Bring a towel if you are not comfortable on the exam table without one. Your personal towel will be placed on the exam table. You will be lying on your personal towel. Why? We are doing our best to minimize medical waste. Use of paper sheets over the table creates unnecessary waste during the REMS exam.
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Wear comfortable, loose-fitting clothing. Your abdomen will be exposed first to perform the exam for the lumbar spine. To perform the exam for the hip, the inguinal crease (groin) will need to be exposed. You will be asked to bring your pants to mid-thigh to access the inguinal crease. Please wear underwear.
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Avoid eating a meal or drinking 2-3 hours prior to your exam. Gas in the intestines will interfere with the lumbar spine exam.
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Missoula Physical Therapy does not accept insurance of any kind. Direct payment for service is accepted at time of exam.
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Your test will be sent via email of your choice. It will not be a secure email. If you would like to have it at the time of your exam, please bring a usb drive with window/PC compatibility.