The DEXA scan can be fooled to give a falsely normal result in the lumbar spine if there are large osteophytes (bone spurs) due to degenerative arthritis. The osteophytes interferes with the DEXA beam.
Rheumatoid Arthritis and Osteoporosis
I have had RA for about 6 years on mtx 15, pred 3 mg, plaq 400 mg and various other nsaids, along with vitamins including 1200 mg of calcium a day. Last December 2002 I had a dexa scan which showed a T-score of -0.61 (94% of young normal values) and Z-score of +0.14 (102% of age match normal values in the lumbar spine and pelvis. I have been having very severe lower back pain and pain in my hips for the past three months…thought maybe it was a new mattress problem, as my right hip would be totally numb and very painful when I would wake up. I moved to the sofa. I went and saw my internist who order Lumbar spine x-rays and pelvis x-rays. I have severe osteoarthritis at L5 with facet hypertrophy throughout the lower spine. Pelvis ok. But, the worse part is my spine has moderate osteoporosis. L3 thorugh 5 have no trabecula left and are very transparent. My question is how can someone with such a great Dexa just 13 months ago, go to plain films like this? I am 51 and have been trying to get through menopause this past year, with very irregular periods. I take no hormones. There is no family history of osteoporosis. My estrogen level in October was normal. Thank you for your time.