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

Osteoporosis International volume 20, pages 1347–1352 (2009)Cite this article

Abstract

Summary

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.

Introduction

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).

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

This study was supported and funded by F. Hoffmann-LaRoche, Ltd. and GlaxoSmithKline. The authors would like to acknowledge Nicole van de Griend, MSc, and Carien Gierveld, MSc, of GlaxoSmithKline for research assistance.

Conflicts of interest

This study was supported and funded by Roche and GSK. Dr J.C. Netelenbos, Dr W.F. Lems, Dr P.P. Geusens, Dr H.J. Verhaar, Dr A.J.M. Boermans, and Dr S.E. Papapoulos have no conflict of interest, including specific financial interest and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript. Dr M.M. Boomsma is an employee of GSK. Dr P.G.H. Mulder has served as a consultant for GSK.

Author information

Affiliations

  1. Department of Endocrinology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    J. C. Netelenbos

  2. Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands

    W. F. Lems

  3. Department of Internal Medicine/Rheumatology, University Hospital, Maastricht, The Netherlands

    P. P. Geusens

  4. University Hasselt, Hasselt, Belgium

    P. P. Geusens

  5. Mobility Laboratory, Department of Geriatric Medicine, University Medical Center, Utrecht, The Netherlands

    H. J. Verhaar

  6. Lutterstraat 2a, NL-7581 BV, Losser, The Netherlands

    A. J. M. Boermans

  7. Medical department, GlaxoSmithKline, Zeist, The Netherlands

    M. M. Boomsma

  8. Erasmus University Medical Center, Rotterdam, The Netherlands

    P. G. H. Mulder

  9. Department of Endocrinology and Metabolic Diseases, University Medical Center, Leiden, The Netherlands

    S. E. Papapoulos

Authors
  1. J. C. Netelenbos
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  2. W. F. Lems
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  3. P. P. Geusens
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  4. H. J. Verhaar
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  5. A. J. M. Boermans
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  6. M. M. Boomsma
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  7. P. G. H. Mulder
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  8. S. E. Papapoulos
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Corresponding author

Correspondence to J. C. Netelenbos.

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Netelenbos, J.C., Lems, W.F., Geusens, P.P. et al. Spine radiographs to improve the identification of women at high risk for fractures. Osteoporos Int 20, 1347–1352 (2009). https://doi.org/10.1007/s00198-008-0801-1

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  • DOI: https://doi.org/10.1007/s00198-008-0801-1

Keywords

  • Bone mineral density
  • Case finding
  • Dual-energy X-ray absorptiometry
  • Spine radiographs