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Vertebral Imaging in the Diagnosis of Osteoporosis: a Clinician’s Perspective

  • Therapeutics and Medical Management (S Jan de Beur and B Clarke, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Vertebral fractures are the most common osteoporotic fracture and result in functional decline and excess mortality. Dual-energy x-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis to identify patients at risk for fragility fractures; however, advances in imaging have expanded the role of computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating bone health.

Recent Findings

The utility of CT and MRI in the assessment of bone density is starting to gain traction, particularly when used opportunistically. DXA, conventional radiography, CT, and MRI can all be used to assess for vertebral fractures, and MRI can determine the acuity of fractures. Finally, advances in imaging allow for non-invasive assessment of measures of bone quality, including microarchitecture, bone strength, and bone turnover, to help identify and treat at-risk patients prior to sustaining a vertebral fracture.

Summary

CT and MRI techniques remain primarily research tools to assess metabolic bone dysfunction, while use of DXA can be clinically expanded beyond measurement of bone density to assess for vertebral fractures and bone architecture to improve fracture risk assessment and guide treatment.

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, 02115, USA

    Sharon H. Chou & Meryl S. LeBoff

  2. Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA

    Sharon H. Chou & Meryl S. LeBoff

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  1. Sharon H. Chou
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Chou, S.H., LeBoff, M.S. Vertebral Imaging in the Diagnosis of Osteoporosis: a Clinician’s Perspective. Curr Osteoporos Rep 15, 509–520 (2017). https://doi.org/10.1007/s11914-017-0404-x

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