What To Expect During
A Scan
There is no need to wear any special clothing; loose trousers and a top are fine.
You won't need to completely undress, you simply expose two areas of your body (hip and tummy) when required.
The scan procedure is simple and painless.
You are asked to lie on a couch fully dressed.
The hips are scanned first so you will need to roll your trousers down to just above your knees. Some ultrasound gel is applied and you will feel a bit of pressure when the scans are in progress. This takes less than a minute.
The spine is scanned through your navel area, so you will be asked to roll up your top for this. This scan is completed in under two minutes again with a little bit of gel and downward pressure.
The results of screening are available immediately and the bone health specialist will then discuss them with you. They will explain how the scan assesses your future fracture risk and will offer advice and guidance as to how to improve your bone health by addressing factors such as diet and exercise.
Your results are emailed to you so you have them for future reference.
A comprehensive report will be generated and emailed to you with the information that will have been discussed. This is in a format that your GP or treating specialist will find understandable.
The whole appointment takes 60 minutes.
A REMS scan provides an estimate of bone mineral density (BMD), a T-score, a Z-score and a Fragility Score. A combination of the T-score and Fragility Score is used to calculate future fracture risk. Ultrasound technologies such as REMS (radiofrequency echographic multi-spectrometry) and QUS (quantitative ultrasound) are only recognised as screening tools, by the NHS and the Royal Osteoporosis Society (ROS). They recognise DXA as the “Gold Standard” diagnostic tool to diagnose osteoporosis, provide follow-up information about bone health over time and monitor bone health responses to treatment. Therefore, in the UK, REMS is not yet considered a diagnostic device by the NHS or a suitable technology for monitoring by the ROS. It is, however, licensed for use by the MHRA as a screening tool for bone health. Therefore, having a REMS scan does not replace other recognised and validated bone densitometry tests arranged by licensed medical practitioners.
Ensuring quality
Nick has 29 years’ experience as a consultant spinal and bone health consultant and has annual GMC mandated appraisals that ensure he maintains his knowledge and skills at levels that are needed to fulfil his clinical role. His bone health knowledge has been accumulated from the time he was training in London in the 1990s and he has published and lectured on bone biology extensively since then. REMS training is formally conducted in Lecce, Italy at the home of Echolight. This consists of a three-day practical and classroom programme. The practical component is held in the rheumatology hospital in Lecce where hands-on training with patients who are being actively treated means REMS scans can be carried out under supervision of a trainer. During the classroom sessions the unique core technology of REMS is taught along with the key features that REMS and DEXA share. At the end of the course an exam is taken and only after completion of the full course and success in the exam can the practitioner be certified. Nick achieved certification in July 2018 having performed 19 REMS scan and after passing the exam with no wrong answers. In November 2024 Nick recertified his REMS technology credentials and has been accredited as an Echolight "Train the Trainers" professional.
On return to the UK, he set up the OsteoscanUK REMS service and for the first six weeks offered free scans to any patients, staff, colleagues or friends who wished to avail themselves so that he could rapidly climb what he recognised would be the continuing learning curve. By mid-September 2018, after completing a further 123 REMS scans analysis of test / retest data indicated that he had achieved competence in carrying out REMS bone densitometry following which OsteoscanUK was launched as a commercial service. Ongoing quality assessment within OsteoscanUK takes two forms. The equipment is formally calibrated every month using the specific Echolight calibration phantoms and software. REMS scanning quality maintenance is ensured by ongoing audit of all scans to assess their compliance with the ISCD quality criteria for bone densitometry.