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Who Needs a REMS Scan?
Are you concerned about low bone mineral density (BMD)?
Anyone who's had a bad DXA result needs a REMS scan. Consider the REMS the second opinion to the DXA scan. The problem is DXA simply does not tell the whole story about your bones.
DXA only measures the density of your outer layer of bone. It tells you nothing about the quality or strength of your inner bone.
REMS assesses both the density of your outer layer and the quality of your inner bone. That is crucial to accurately predicting fracture risk.
The problem with BMD
Bone mineral density alone is so unreliable that in 2025 the International Osteoporosis Foundation published a paper, endorsed by 87 osteological societies worldwide, calling for BMD to be replaced as the threshold for diagnosis and treatment of osteoporosis.
Are you under pressure to take bone meds?
For many women, a diagnosis of osteopenia or osteoporosis means immediate pressure from a doctor to start taking so-called, "bone meds." For those who are apprehensive about those meds, it should be comforting to know that low BMD (or a bad T-score) often occurs in women who nevertheless have sound bone structure, and therefore are at a low risk for fragility fracture.
The REMS scan can reveal this, and having a REMS result in hand can arm you against the pressure to get on meds. In many cases, you will find your provider curious and supportive about the more nuanced and comprehensive diagnostic result!
What to expect at a REMS event
Allow 45 min for the procedure. Scans may go more quickly, but I want to leave time to answer questions.
You will receive a scan of both hips and your lumbar spine from certified REMS tech Ashley Strand. Your results will be explained to you and shared with you via email the same day. The results then belongs to you, to use as you please.
Depending on how travel distance and attendance, between $200-$250.
For those interested in more in-depth discussion of their results, a follow-up phone consultation with our expert REMS consultant, Dr Andrew Bush, may be scheduled for an additional fee of $150.
Please scroll down to find some handy resources about REMS, from brief descriptions to detailed explanations.
Echolight REMS: Because You Want the Best Bone Scan
Who Needs a REMS Scan?
Why Is REMS the Most Complete Bone Scan?
Point-by-Point: How REMS Beats DXA
REMS in 3min
Point-by-Point: How REMS Beats DXA
Why Is REMS the Most Complete Bone Scan?
Point-by-Point: How REMS Beats DXA
REMS in 9min
Why Is REMS the Most Complete Bone Scan?
Why Is REMS the Most Complete Bone Scan?
Why Is REMS the Most Complete Bone Scan?
REMS in 11min
Echolight R.E.M.S. Greensboro, NC
Echolight R.E.M.S. Greensboro, NC
Echolight R.E.M.S. Greensboro, NC
Introducing the Echolight R.E.M.S., an FDA-approved bone-density and bone-fragility test that uses cutting edge ultrasound technology that gives you the most accurate and comprehensive fracture risk assessment available today!
Better Bones is proud to be the first (and currently ONLY) REMS provider in Greensboro. Our expert REMS consultant, Dr Andrew Bush, has been an orthopedic surgeon for 25 years and is a top-three REMS practitioner nationwide.
REMS provides a direct trabecular assessment that DXA can't and yields a fracture risk -- or "fragility" -- score that is much more accurate. According to published, peer-reviewed research and over a decade of clinical use, many clinicians believe Echolight to be the new, gold-standard for bone fracture risk assessment.
DXA scans only tell you about your bone mineral density (BMD). They tell you nothing about bone quality (i.e. bone strength). Echolight R.E.M.S. tells you both.
REMS generates an instantaneous medical report, including BMD (g/cm2), T-score, and Z-score, as well as a fragility score and a percent likelihood of fracture in the next five years.
The ultrasound appointment can go as fast as 15min, but is scheduled for 45min to allow time for discussion.
Learn more at Echolight.
Why Does REMS Beat DXA?
Echolight R.E.M.S. Greensboro, NC
Echolight R.E.M.S. Greensboro, NC
Did you know that studies have shown that more than 90% of DXA's have errors? What's more DXA is a poor predictor of fracture risk. Did you know that 50% of fragility fractures occur in people who do NOT have osteoporosis?
A summary of the advantages REMS has over DXA:
- 10x smaller margin of error (0.5 vs. 5%)
- Zero ionizing radiation
- Meaningful changes to bone discernible in 3-6 mos vs 2 yrs
- Results not confounded by
- Hardware
- Inflammation
- Abnormal bony growth
- Different machine
- Different operators
- Different positions
- Results are automatic and instantaneous — results are yielded, not interpreted, eliminates high rate of errors in DEXA
- Most important: DEXA only measures cortical bone mineral density. It DOES NOT measure the quality of the trabecular bone, the inner matrix of bone which gives bone its strength. REMS measures both cortical BMD and trabecular quality, giving the best approximation of your true fracture risk.
Learn more at Echolight.
Why Is REMS Better Than DXA?
Deep Dive with Our Expert Consultant
In this longer video, our Expert REMS consultant, Dr. Andy Bush explains in detail why bone strength needs to be measured to determine fracture risk.
Deep Dive with Our Expert Consultant
In this sequel, our Expert REMS consultant, Dr. Andy Bush explains in detail why bone strength needs to be measured to determine fracture risk.
About
Owner Ashley Strand
Ashley Strand is an entrepreneur, a certified REMS tech and BioDensity coach, former manager of OsteoStrong Greensboro, and has helped hundreds of women with age-related bone loss to improve their bone health. He is dedicated to safety, good form, listening to, and caring for his clients.
Expert REMS Consultant Dr Andrew Bush
Dr Andrew Bush was an orthopedic surgeon for 25 years before changing his focus from fracture repair to fracture prevention. Since then the REMS scan has become central to his practice. Dr Bush is top REMS practitioner nationwide. A pioneer in the field, he has over 3,000 scans, he has performed and analyzed more REMS scans than anyone in the US. He runs Central Carolina Orthpedic in Pittsboro, NC.
Our Philosophy
Better Bones is proud to be the first REMS provider in the Triad. We believe the best treatment begins with the best diagnosis, that strength is bone health, that bone health is inseparable from overall health, and that results should be measurable and tracked.
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