I have a pacemaker / loop recorder / spinal cord stimulator (or any other implantable electronic device).
If you have been fitted with any implantable electronic medical device, you can have a REMS scan. Both you and the device will come to no harm and the presence of the device will not affect your scan results.
 

I have a hip replacement.
You cannot have a scan on the side of the hip replacement, but if the other side has not been replaced, it can be scanned.
 

I broke my hip and it has been fixed.If you have had a fracture fixed with screws or a nail into the thigh bone, you can have a REMS scan. However, if your fracture was treated with a half or full hip replacement then we are unable to scan that hip. If this is the case, your other hip can be scanned as is usual practice (both hips are scanned as a matter of course). If you have had both hips replaced, you will still be able to have your spine scanned.

 

I am in a wheelchair and have restricted mobility.

Although wheelchair access is possible at almost all external OsteoScan UK clinics, the couch height is fixed which makes it unsuitable for most transfers from wheelchairs. However, if you can easily self-transfer to an examination couch, or transfer with minimal assistance, you can have a scan at the Bragborough clinic where the couch can be raised and lowered as needed.  If you are unable to self-transfer, then arrangements can be made to have a scan at a neurological physiotherapy centre in Northamptonshire, a few miles away from Bragborough, where they have the equipment needed for more complex transfers.

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I have scoliosis.
Having scoliosis does not affect a REMS scan in most cases. It is very helpful to know ahead of the scan that a person has a scoliosis and if a previous x-ray or DXA scan (with the spinal images) is available that also assists the operator. However, if a person has a scoliosis and has had a fracture in the lumbar region, the combination can make it difficult, or even impossible, to visualise the spine even with REMS.
 

I have had a spinal fusion / I have implants in my back.
You can have a REMS scan if you have had a fusion with metallic implants rods. In most cases, if you have had cement injected into your vertebrae following a fracture (vertebroplasty / kyphoplasty), REMS is unaffected and your spine can be scanned.
 

What happens if I can’t lie flat for a scan?
If you can’t lie flat, but can lie reclined, then you can have a REMS scan.  There are memory foam pillows at our clinics that make it easier for someone with a painful or curved spine to lie down. Additionally, supporting the legs in a flexed position is often helpful, which is easy to do. The scan part of the appointment usually lasts for 15 – 20 minutes so patient comfort is of great importance and all efforts will be made to ensure the time spent lying is as comfortable as possible. It is very helpful for us to know about lying down difficulties ahead of the clinic appointment so please alert us when booking.

 

I have a very low (or high) BMI?  
If you are visiting a mobile regional clinic, a portable couch and the mobile EchoS machine is used for the scans with a weight range of 30-130kg. If you weigh more than 130 kg, but your body mass index (BMI) is less than 40 Kg/m 2 , you will have to have a scan at the Braunston clinic where the mechanical couch has a higher weight rating.

 

Is there an age range of people who can have a scan?

There is no upper age range for a REMS scan, although the report generated by the REMS scan only provides the age-related Z scores up to 85 years of age. The T- scores and Fragility Scores are reported with higher ages. The REMS software allows the lowest age of people being scanned as 21 years. T scores, Z scores and Fragility Scores will be generated, but T scores should be ignored as they are not relevant until a person is 30 or older. In younger people, REMS scans are possible by labelling the patient as “21 years old” following which the Z scores and Fragility Scores can be adjusted using international tables that allow age matched estimates of bone density and bone toughness to be produced.
 

Can I bring someone else into my appointment?
Absolutely!  Two pairs of eyes and ears are better than one pair of each. If you wish to tape/record your appointment, you can do so as well.

 

Do you send my scan results to my GP?

We email you the reports for your hips and spine (4 pages for each hip and 5 for the spine) for your own use but we do not send them to your GP. If you wish your GP to see your results you need to forward them to the practice yourself.
 

What if after I have had my scan I have left and then realise I have more questions or need more guidance?  

You can book a Zoom appointment with Mr Birch. These should be booked via his PA, Kathy (07534 609934). His Zoom fees are £150 for 30 minutes and £300 for 60 minutes.  An alternative option, if you have a complex past history and have lots to go through, is to book a double appointment at a clinic.
 

Can my specialist/GP be sent a detailed letter describing my scan results?
This can be done on an ad hoc basis. There is an additional cost of £150 per letter.

 

All the clinics I want are full. How can I get an appointment quickly?
If you cannot wait until one of the regional clinics and you can travel to Mr Birch's full- time consulting rooms in Braunston (NN11 7JG), you will get in far sooner than waiting for a regional clinic. The Braunston clinic runs on most Mondays and Wednesdays as well as Thursday mornings. Contact his PA, Kathy (07534 609934) to book the appointment.
 

What should I wear?  
For women, there is no need to wear any special clothing, just a loose pair of trousers and a normal top. You will not need to completely undress. For the hip scans, your trousers need to be pushed down to your knees and the dignity of your private areas will be protected with a towel.

For the spine scan, the abdomen from the ribcage to the pelvis is exposed, again with dignity carefully preserved.

For men, wearing briefs is a better option than boxer shorts as it means getting access to the front of the hips is made easier.

 

Can I eat before a scan?  
Formally fasting before a scan is not necessary, but it is sensible not to have a heavy meal in the three hours before the appointment. Fluids at any time up to the scan are fine.
If you have known intestinal problems that produce a lot of bloating with gas, it is worth keeping to a bland diet for the 24 hours ahead of the scan to try to reduce the amount of gas in the bowel. REMS uses ultrasound which is unable to visualise the spine through bowel that has gas in it. Having a significant amounts of gas in the bowel is the commonest reason not to be able to get a good result for the spine.
 

What if I need to cancel my booked scan?
OsteoscanUK has a comprehensive Cancellation policy which can be read here