REMS vs DEXA:
What’s the Difference?
Both REMS and DEXA are used to assess bone health. The difference is how they measure—and what that means for clarity, comfort, and confidence in the result.
If you only read one section, read this
DEXA uses a low-dose X-ray to estimate bone mineral density (BMD) using a 2D projection.
REMS is an advanced ultrasound-based technology that analyzes raw radiofrequency signals to estimate BMD at clinically relevant sites—without ionizing radiation.
REMS vs DEXA (at a glance…)
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REMS: Ultrasound with radiofrequency signal analysis
DEXA: X-ray (dual-energy absorptiometry)
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REMS: No ionizing radiation
DEXA: Uses ionizing radiation (low dose)
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REMS: Designed to reduce the impact of common X-ray “artifact” issues in real-world bodies
DEXA: Can be influenced by artifacts—especially in the lumbar spine—such as degenerative changes/osteophytes and vascular calcifications that can falsely elevate BMD.
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REMS: Studies report good accuracy/precision compared with DXA, with the caveat that operator training and proper acquisition matter.
DEXA: Longstanding standard with broad availability
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REMS: Prospective data supports REMS-derived measures for predicting incident fragility fractures in studied populations.
DEXA: BMD correlates with fracture risk, but BMD alone does not fully capture bone quality.
WHY REMS IS DIFFERENT
REMS (Radiofrequency Echographic Multi-Spectrometry) analyzes raw ultrasound radiofrequency signals to estimate BMD at key sites such as the lumbar spine and femoral neck. Multiple studies have compared REMS and DXA and report strong agreement and clinically useful performance, while emphasizing the importance of correct acquisition and training.
REMS is also FDA-cleared in the U.S. for its intended use (EchoS Family and related clearances).
REMS uses signal-level ultrasound analysis—without radiation
WHY DEXA CAN BE MISLEADING FOR SOME PEOPLE
DEXA is a valuable tool, but because it is a 2D X-ray projection, anything dense in the X-ray path can affect the reading. In the lumbar spine, common issues like degenerative changes (osteophytes) and vascular/aortic calcification can lead to falsely elevated BMD—sometimes masking osteoporosis risk.
A key limitation: artifacts can inflate lumbar spine BMD
This is one reason some people receive “normal” or “stable” spine results even when clinical risk factors suggest closer evaluation is warranted.
REMS may be especially helpful if…
- You want a radiation-free assessment
- You are monitoring bone health and want repeatable follow-up over time
- You have known or suspected spine degeneration/arthritis, where DXA spine readings may be less reliable
- You want an assessment designed to support risk insight, not just a single number
WHAT TO EXPECT AT SONOHEALTH CA
A calm, precise clinical experience
Verification of key details to support accurate reporting
A guided, comfortable scanning process
A clear results discussion and practical next-step guidance
Important note: no test is perfect
REMS is clinically validated, but like any technology, results depend on correct acquisition and trained operation. We take that seriously—because the quality of the scan process directly impacts the quality of the information.
Can REMS replace DEXA?
REMS is an FDA-cleared, clinically supported alternative assessment method. Some people use it alongside DEXA, and some use it when they want a radiation-free approach or added clarity.
Ready to compare with confidence?
Book your REMS scan and get results reviewed clearly—with next steps you understand.
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