Spine radiographs to improve the identification of women at high risk for fractures
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.
KeywordsBone mineral density Case finding Dual-energy X-ray absorptiometry Spine radiographs
- 1.Anon (2002) America’s bone health: the state of osteoporosis and low bone mass in our nation. National Osteoporosis Foundation, Washington (DC)Google Scholar
- 2.Anon (2004) Bone health and osteoporosis: a report of the surgeon general. Rockville (MD): US Department of Health and Human Services, Office of the Surgeon General. Available at http://www.surgeongeneral.gov/library/bonehealth/ [last accessed 7 June 2007]
- 3.RIVM osteoporosis fact sheath, available at http://www.rivm.nl/vtv/object_document/o1793n18373.html [last accessed at 7 June 2007]
- 7.CBO Guideline Osteoporosis; second revised guideline. Available at http://www.cbo.nl/product/richtlijnen/folder20021023121843/osteoporose.pdf/view