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Clinical application of radiofrequency echographic multi-spectrometry (REMS) for diagnosis and follow-up in several rare bone disorders: a case series

Caffarelli C, Mondillo C, Versienti A, Gonnelli S, Cavati G, Tomai Pitinca MD, Gonnelli S, Al Refaie A

BMC medical imaging, 2025

Abstract

Radiofrequency Echographic Multi Spectrometry (REMS) is a portable and radiation-free technology that can evaluate and monitor osteoporosis. In particular, REMS has been shown to measure bone mineral density (BMD) at axial skeletal bones with a precision, repeatability and accuracy not inferior to those of dual-energy X-ray absorptiometry (DXA). Moreover, REMS may be useful in the assessment of impaired bone quality and to predict fragility fracture risk. Due to these characteristics, REMS could be usefully used in the diagnosis and follow up of osteoporosis in rare bone diseases. The clinical cases includes in this study were selected among those that best highlight the strengths of REMS technology. A recent study conducted on subjects affected by osteogenesis imperfecta has demonstrated that the REMS technique is able to assess BMD in the same way as the DXA evaluation. REMS has also demonstrated excellent diagnostic accuracy in some patients suffering from others rare disease such as McCune-Albright or Ehlers-Danlos syndromes. Furthermore, REMS could be particularly advantageous in children and in women of childbearing age or during pregnancy and breastfeeding. In conclusion, on the basis of these preliminary data, REMS can be usefulness for the evaluation and monitoring of bone in individuals with rare bone diseases.

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