In previous posts, you’ve read about the limitations of the DEXA scan to provide a comprehensive analysis of bone health and determination of fracture risk (See DEXA Scans - What they don’t tell you - Part 2). Since that post, there’s been a buzz about a new technology that’s been getting a lot of well-deserved attention in the world of researchers, practitioners and clients looking for a better way to identify who’s really at risk for fracture.

This new groundbreaking technology is called REMS, an acronym for Radiofrequency Echographic Multi Spectrometry and it could revolutionize how we assess bone health. The company that is making this REMS device, Echolight, is based in Italy where it is rapidly being adopted as an alternative to the “gold-standard” DEXA scan…..and for good reason:

REMS testing provides a very accurate bone mineral density (BMD) complete with T-scores and Z-scores like a DEXA scan AND…
In addition, it provides valuable information about your bone’s microarchitecture which is analogous to the quality of the bone - something that a DEXA scan is unable to assess. And we know that both bone quantity (BMD) + bone quality (microarchitecture) are necessary to accurately predict fracture risk
The Echolight REMs unit also utilizes software that measures body composition and provides valuable information about lean body mass. This is important because muscle dynamics influence bone dynamics. The more lean body mass the better your bone quality.
REMS technology uses non-ionizing ultrasound frequencies so there’s no radiation exposure
Because there is no danger of radiation exposure, the REMS testing is available to a wider range of clients who would benefit from knowing their fracture risk but were unable to qualify for DEXA scans according to insurance guidelines
The device is small and mobile. It does not require a dedicated room with expensive equipment or specialized operators
Your REMS report is issued on the spot
It does not require a prescription
Results are not affected by the presence bony artifact of degenerative joint disease, ie arthritis

REMS Accuracy

Seems almost too good to be true doesn’t it? You might be asking yourself how accurate is REMS testing compared to DEXA?

A 2021 study published in the Archives of Osteoporosis reported the “...The REMS approach had high accuracy for the diagnosis of osteoporosis in comparison with DXA in adult women”. (2)

A literature review published in Diagnostics as recently as May, 2023 found that “...The literature data confirmed diagnostic concordance between BMD values obtained using DXA and REMS. Furthermore, REMS has adequate precision and repeatability characteristics, is able to predict the risk of fragility fractures, and may be able to overcome some of the limitations of DXA”. (1)