Osteoporosis International

, Volume 20, Issue 8, pp 1347–1352

Spine radiographs to improve the identification of women at high risk for fractures

  • J. C. Netelenbos
  • W. F. Lems
  • P. P. Geusens
  • H. J. Verhaar
  • A. J. M. Boermans
  • M. M. Boomsma
  • P. G. H. Mulder
  • S. E. Papapoulos
Original Article

DOI: 10.1007/s00198-008-0801-1

Cite this article as:
Netelenbos, J.C., Lems, W.F., Geusens, P.P. et al. Osteoporos Int (2009) 20: 1347. doi:10.1007/s00198-008-0801-1



In women older than 60 years with clinical risk factors for osteoporosis but without osteoporosis based on bone mineral density (T-score ≥ −2.5), a systematic survey with X-rays of the spine identified previously unknown vertebral deformities in 21% of women.


This study determines the prevalence of vertebral deformities in elderly women with clinical risk factors for osteoporosis but with BMD values above the threshold for osteoporosis (T-score ≥ −2.5).


Bisphosphonate naïve women older than 60 years attending 35 general practices in the Netherlands with ≥2 clinical risk factors for osteoporosis were invited for BMD measurement (DXA). In women with T-score ≥ −2.5 at both spine and the hips, lateral radiographs of the thoracic and lumbar spine were performed.


Of 631 women with a DXA measurement, 187 (30%) had osteoporosis (T-score < −2.5 at the spine or the hip). Of the remaining 444 women with T-score ≥ −2.5 at both spine and hip, 387 had additional spine radiographs, of whom 80 (21%) had at least one vertebral deformity.


In elderly women with clinical risk factors for osteoporosis but BMD T-score ≥ −2.5, addition of spine radiographs identified vertebral deformities in 21% (95% CI: 17–25). Since these women are at risk of future fractures, antiosteoporotic treatment should be considered.


Bone mineral densityCase findingDual-energy X-ray absorptiometrySpine radiographs

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • J. C. Netelenbos
    • 1
  • W. F. Lems
    • 2
  • P. P. Geusens
    • 3
    • 4
  • H. J. Verhaar
    • 5
  • A. J. M. Boermans
    • 6
  • M. M. Boomsma
    • 7
  • P. G. H. Mulder
    • 8
  • S. E. Papapoulos
    • 9
  1. 1.Department of EndocrinologyVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of RheumatologyVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Internal Medicine/RheumatologyUniversity HospitalMaastrichtThe Netherlands
  4. 4.University HasseltHasseltBelgium
  5. 5.Mobility Laboratory, Department of Geriatric MedicineUniversity Medical CenterUtrechtThe Netherlands
  6. 6.LosserThe Netherlands
  7. 7.Medical departmentGlaxoSmithKlineZeistThe Netherlands
  8. 8.Erasmus University Medical CenterRotterdamThe Netherlands
  9. 9.Department of Endocrinology and Metabolic DiseasesUniversity Medical CenterLeidenThe Netherlands