Welcome back to the Stronger Bones Lifestyle Podcast. Today Debi welcomes back spinal surgeon Nick Birch to further discuss DEXA scans, REMS scans and overall bone health. In 2018 Nick founded OsteoscanUK with the intention of offering high quality bone health assessments locally, rather than in a hospital setting, using the Echolight REMS system and has carried out over 2200 REMS scans. Listen today as he discusses typical fractures he sees and some of the reasons behind them, the issues with DEXA scans and the importance of bone density and toughness. Join Nick and Debi as they talk about bone mineral density, comparing your DEXA scan numbers and the correlation between your body's build and your bone density. Key  Takeaways: [2:07] Maddie Young [4:16] What does your DEXA scan number mean [4:51] Correlation between bone density and your build [5:46] Concordant results [7:28] The subtle layer [10:00] What the DEXA scan scans [12:48] The genetic component to osteoporosis [14:28] The commonest error for spinal DEXA scan [17:35] What are my numbers? [18:23] Issues with DEXA [19:58] Comparing DEXAs [22:17] Who determines the osteoporosis diagnosis criteria [24:30] What inspired the creation of the REMS scan [25:22] Bone mineral density [28:00] An X-Ray analogy [28:57] Orthopedic surgeon frustration [30:20] Spine queries [34:16] Typical fractures [35:11] Adductors Where to Find Guest: Website Densitometry Discordance Prevalence of Major and Minor Discordance between Hip and Spine T Scores Using REMS Memorable Quotes: "REMS is taking at least one step towards what an MRI is going to offer for muscular skeletal imaging, rems is taking in the densitometry space." [29:39] - Nick  "Again it comes back to toughness, if the hip is tough because its good strong thick bone then It has to be significantly weakened before it can fractured." [32:19] – Nick "And that’s the thing about yoga that’s so fantastic for osteoporosis is we place our limbs, our joints, in a different range of motion that we would normally and then we weight bear in it." [38:11] - Debi To learn more about me and to stay connected, click on the links below: Instagram: @debirobinsonwellnessWebsite: DebiRobinson.comHealthy Gut Healthy Bones Program