Minnesota's New Standard for Bone Health: A Guide to the Revolutionary REMS Bone Scan
By Dr. Stefano Sinicropi, Founder of HyperCharge Health
Disclaimer: This blog is for informational purposes only and is not intended as medical advice. The treatments described should only be considered after a consultation and under the direct supervision of a qualified medical expert.
A New Standard for Assessing Bone Health Has Arrived in the Twin Cities
As a physician on the front lines of patient care for over two decades, I’ve seen a fundamental gap in our approach to bone health. Whether you are a primary care provider managing preventative screenings, an endocrinologist monitoring complex cases, an integrative practitioner seeking objective data, or a surgeon planning an intervention, we have all been limited by our primary diagnostic tool. We've relied on bone density as a proxy for bone strength, often with frustrating or even devastating consequences.
A revolutionary, radiation-free technology is changing that paradigm, and HyperCharge Health is proud to be a designated Center of Excellence leading the way in Minnesota. This technology is REMS (Radiofrequency Echographic Multi Spectrometry), and it represents the most significant advancement in osteoporosis screening in a generation. At our Edina clinic, we have built a comprehensive program around it called the REMS Plus Evaluation. This blog serves as a deep-dive, evidence-based guide for proactive patients and for the diverse community of clinicians seeking a superior diagnostic tool.
The Deepening Crisis of Bone Fragility
To understand the importance of this new technology, we must first appreciate the scale of the problem. According to the Bone Health and Osteoporosis Foundation, approximately 54 million Americans have low bone mass or osteoporosis [1]. This silent epidemic leads to two million fractures annually in the U.S. alone. A hip fracture, in particular, is a life-altering event. It carries a staggering 20-24% mortality rate in the first year, and for those who survive, nearly 50% will experience a significant loss of independence, with many unable to return to their prior level of function [2]. The economic burden is immense, costing the U.S. healthcare system an estimated $25.3 billion per year for osteoporotic fractures [3]. The core issue is that bone loss is asymptomatic. You cannot feel your bones getting weaker, making proactive and accurate screening absolutely critical.
The Proactive Imperative: Why the Old Screening Model is Failing
The current guideline to wait until age 65 for a woman's first bone density scan is a flawed, reactive model. It fails to account for the accelerated bone loss during the menopausal transition, where women can lose up to 10% of their total bone mass in the first five years after their final menstrual period [4]. Waiting two decades after this process begins to finally screen is a missed opportunity for prevention.
This "wait for disease" approach has been largely dictated by the limitations of the DEXA scan. While it has been the gold standard, it has well-documented drawbacks:
It uses ionizing radiation. This makes physicians hesitant to screen patients early or frequently for monitoring.
It only measures Bone Mineral Density (BMD). BMD is an incomplete predictor of fracture risk. Studies have shown that a majority of non-vertebral fragility fractures occur in patients who are not classified as osteoporotic by DEXA [5].
It can be inaccurate. A common problem in our aging population is that degenerative changes in the spine, such as osteophytes, can falsely elevate BMD readings, giving a dangerously misleading impression of bone strength [6].
Introducing REMS Technology: The New Gold Standard in Bone Health Assessment
REMS is a cutting-edge, ultrasound-based approach that overcomes the limitations of DEXA. Foundational validation studies published in leading journals have confirmed that REMS-derived BMD values show a very high correlation with DEXA values, establishing its accuracy as a diagnostic tool [7]. But its true power lies in what it measures beyond density.
The Clinical Power of a Dual Assessment: T-Score and Fragility Score
REMS analyzes the raw ultrasound signal as it interacts with the bone's internal microarchitecture. This provides two critical data points: a highly accurate BMD T-score and a revolutionary Fragility Score. This Fragility Score is a direct assessment of bone quality. A landmark 2021 study demonstrated that the REMS Fragility Score could independently predict fragility fractures over a 5-year follow-up period. Critically, it identified a significant number of at-risk patients who would have been missed by a density-only assessment [8]. This allows for profoundly more nuanced and accurate clinical decisions.
The Undeniable Advantages Over DEXA
Completely Radiation-Free: Safe for any patient, at any age, allowing for early baseline screening and frequent, risk-free monitoring.
Assesses Bone Quality: The evidence-based Fragility Score provides a more complete picture of true fracture risk.
Unaffected by Artifacts: REMS is not skewed by degenerative changes, providing a more accurate reading [6].
Immediate, Actionable Results: Patients and their referring providers receive a comprehensive report immediately, facilitating seamless care across the Minneapolis-St. Paul medical community.
The Clinical Advantage: A Multi-Disciplinary Perspective on REMS
REMS technology provides actionable data that enhances care across a wide range of specialties.
For Primary Care & Endocrinology: The radiation-free nature of REMS makes early screening in perimenopausal women a safe and responsible option. The Fragility Score is invaluable for risk stratification in osteopenic patients, helping to guide decisions on when to initiate pharmacological treatment and providing a safe, reliable way to monitor efficacy without repeated radiation [8].
For Integrative Health, Naturopathic & Chiropractic Care: REMS is the ultimate tool for preventative medicine. It provides the objective, quantifiable data needed to validate your non-pharmacological protocols. For the first time, you can clearly demonstrate the positive impact of interventions like Vitamin K2 and D3 supplementation—which studies show work synergistically to improve bone quality [9]—on a patient's bone health over time.
For Orthopedic, Spine & Maxillofacial Surgery: A successful surgical outcome depends on the quality of the "surgical substrate." A growing body of literature confirms that poor bone quality, independent of BMD, is a significant risk factor for complications like screw loosening in spinal fusions and periprosthetic fractures in joint replacements [10]. The REMS Fragility Score provides a direct, functional assessment of bone strength, offering invaluable data for pre-operative planning and risk mitigation.
The HyperCharge Health Solution: The REMS Plus Evaluation & Beyond
A superior diagnosis is the first step. Our REMS Plus Evaluation includes the scan followed by a full consultation to build a personalized, multi-modal protocol. Our integrative toolkit—the most comprehensive in Minnesota—is built on evidence-based principles:
Hormonal Optimization: Restoring bone-protective hormones like estrogen and testosterone is a cornerstone of preventing age-related bone loss [11].
Advanced Muscle Building: It is well-established that mechanical loading from resistance exercise stimulates bone growth (Wolff's Law) [12]. We amplify this effect with technologies like our Neuro20 suit and EmSculpt NEO.
Peptide Therapies: Utilizing specific peptides like BPC-157 and Growth Hormone Secretagogues to support fracture healing and bone remodeling.
Targeted Biohacking: Employing Pulsed Electromagnetic Field (PEMF) therapy, which has been shown in numerous studies to stimulate bone-building osteoblast activity and enhance bone formation [13].
This is the future of bone health management—proactive, personalized, and precise.
If you are a patient concerned about your bone health or a **clinician—from primary care to chiropractic to surgical specialties—**looking for a superior diagnostic option for your patients, we invite you to connect with us to learn more about our REMS Plus Evaluation.
Contact HyperCharge Health to Schedule Your Comprehensive REMS Plus Evaluation in Edina.
References
Bone Health and Osteoporosis Foundation. (2021). Osteoporosis Fast Facts.
Veronese, N., et al. (2017). Epidemiology and social costs of hip fracture. Injury, 48(7), 1428-1433.
Burge, R., et al. (2007). Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. Journal of Bone and Mineral Research, 22(3), 465-475.
Karlamangla, A. S., et al. (2009). Bone loss in midlife women: a 10-year follow-up study. The Journal of Clinical Endocrinology & Metabolism, 94(9), 3376–3383.
Siris, E. S., et al. (2001). Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA, 286(22), 2815-2822.
Adami, G., et al. (2021). Radiofrequency echographic multi spectrometry for the diagnosis of osteoporosis in routine clinical practice. Osteoporosis International, 32(8), 1541–1548.
Casciaro, S., et al. (2019). An advanced fully non-ionizing technique for the diagnosis of osteoporosis: a review of the underlying principles and the main clinical evidence. La radiologia medica, 124(12), 1278–1290.
Pisani, P., et al. (2021). Can radiofrequency echographic multi-spectrometry (REMS) predict incident fragility fractures? A 5-year longitudinal, retrospective, real-life study. Bone, 143, 115748.
van Ballegooijen, A. J., et al. (2017). The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review. International Journal of Endocrinology, 2017, 7454376.
Peris, P., & Guañabens, N. (2014). Bone mineral density and quality in the prediction of fragility fracture. Current Opinion in Rheumatology, 26(5), 558–564.
Khosla, S., & Monroe, D. G. (2018). Regulation of bone metabolism by sex steroids. Cold Spring Harbor Perspectives in Medicine, 8(1), a031211.
Frost, H. M. (1994). Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians. The Angle Orthodontist, 64(3), 175-188.
Pawluk, W. (2017). Pulsed electromagnetic fields for the treatment of osteoporosis. Therapeutic Delivery, 8(11), 957-972.