Osteoporosis International

, Volume 20, Issue 8, pp 1347–1352

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


    • Department of EndocrinologyVU University Medical Center
  • W. F. Lems
    • Department of RheumatologyVU University Medical Center
  • P. P. Geusens
    • Department of Internal Medicine/RheumatologyUniversity Hospital
    • University Hasselt
  • H. J. Verhaar
    • Mobility Laboratory, Department of Geriatric MedicineUniversity Medical Center
  • A. J. M. Boermans
  • M. M. Boomsma
    • Medical departmentGlaxoSmithKline
  • P. G. H. Mulder
    • Erasmus University Medical Center
  • S. E. Papapoulos
    • Department of Endocrinology and Metabolic DiseasesUniversity Medical Center
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