Top

Osteoporosis International

Published in:

01-02-2014 | Original Article

Efficacy of the dynamic radiographs for diagnosing acute osteoporotic vertebral fractures

Authors: R. Niimi, T. Kono, A. Nishihara, M. Hasegawa, A. Matsumine, T. Kono, A. Sudo

Published in: Osteoporosis International | Issue 2/2014

Abstract

Summary

We investigated the efficacy of dynamic radiographs for diagnosing acute osteoporotic vertebral fractures (OVFs) compared with supine radiographs or sitting radiographs alone. Evaluation of the dynamic radiographs was superior to the other evaluations. Dynamic radiographs provide a convenient and useful method of diagnosing acute OVFs.

Introduction

Identifying acute OVFs on plain radiographs is difficult. We studied a new approach to identify acute OVFs on the basis of fracture mobility.

Methods

We performed a retrospective radiographic analysis of 472 acute OVFs (<3 weeks after onset), which were diagnosed on the basis of magnetic resonance imaging of T5 through L5 (a total of 5,239 vertebrae). Supine lateral radiographs were compared with sitting lateral radiographs to determine the presence or absence of mobility. Vertebrae showing changes in the vertebral body height were diagnosed as acute OVFs. We analyzed the diagnostic accuracy on the basis of comparative supine and sitting lateral radiographs and compared it with that of radiographs obtained in the supine or the sitting position alone.

Results

Of the 472 acute OVFs diagnosed, 313 (66 %) exhibited vertebral mobility on supine lateral and sitting lateral radiographs. Correct diagnoses of acute OVFs or no acute OVFs were made in 4,883 vertebrae. There were 159 unreadable OVFs (3 %), and 197 previous OVFs (4 %) were misdiagnosed as acute OVFs. The sensitivity was 66 % and the specificity was 96 %. Evaluation of the mobility of acute OVFs in the supine and the sitting position was superior to evaluation using radiographs in either the supine or the sitting position alone.

Conclusions

Dynamic radiographs provide a convenient way to identify acute OVFs.

Ross PD, Davis JW, Epstein RS, Wasnich RD (1994) Pain and disability associated with new vertebral fractures and other spinal conditions. J Clin Epidemiol 47:231–239PubMedCrossRef

Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMedCrossRef

Black DM, Arden NK, Palermo L, Pearson J, Cummings SR (1999) Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group. J Bone Miner Res 14:821–828PubMedCrossRef

Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148PubMedCrossRef

Jiang G, Eastell R, Barrington NA, Ferrar L (2004) Comparison of methods for the visual identification of prevalent vertebral fracture in osteoporosis. Osteoporos Int 15:887–896PubMedCrossRef

Hurxthal LM (1968) Measurement of anterior vertebral compressions and biconcave vertebrae. Am J Roentgenol Radium Ther Nucl Med 103:635–644PubMedCrossRef

Pham T, Azulay-Parrado J, Champsaur P, Chagnaud C, Legré V, Lafforgue P (2005) “Occult” osteoporotic vertebral fractures: vertebral body fractures without radiologic collapse. Spine (Phila Pa 1976) 30:2430–2435CrossRef

Facizewski T, McKiernan F (2002) Calling all vertebral fractures: a consensus for comparison of treatment and outcome. J Bone Miner Res 17:185–191CrossRef

Kawaguchi S, Horigome K, Yajima H, Oda T, Kii Y (2011) Comparative supine-sitting lateral radiographs identifying incident osteoporotic vertebral fractures. Eur Orthop Traumatol 1:157–162CrossRef

10.

McKiernan F, Faciszewski T, Jensen R (2006) Latent mobility of osteoporotic vertebral compression fractures. J Vasc Interv Radiol 17:1479–1487PubMedCrossRef

11.

McKiernan F, Jensen R, Faciszewski T (2003) The dynamic mobility of vertebral compression fractures. J Bone Miner Res 18:24–29PubMedCrossRef

12.

Wu MH, Huang TJ, Cheng CC, Li YY, Hsu RW (2010) Role of the supine lateral radiograph of the spine in vertebroplasty for osteoporotic vertebral compression fracture: a prospective study. BMC Musculoskelet Disord 11:164PubMedCentralPubMedCrossRef

13.

Mehta JS, Reed MR, McVie JL, Sanderson PL (2004) Weight-bearing radiographs in thoracolumbar fractures: do they influence management? Spine (Phila Pa 1976) 29:564–567CrossRef

14.

Faciszewski T, McKiernan F (2002) Calling all vertebral fractures classification of vertebral compression fractures: a consensus for comparison of treatment and outcome. J Bone Miner Res 17:185–191PubMedCrossRef

15.

Reinhold M, Knop C, Beisse R, Audigé L, Kandziora F, Pizanis A, Pranzl R, Gercek E, Schultheiss M, Weckbach A, Bühren V, Blauth M (2010) Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, Internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery. Eur Spine J 19:1657–1676PubMedCentralPubMedCrossRef

16.

Loewen S, Philp J (2006) Recasts in the adult L2 classroom: characteristics, explicitness, and effectiveness. Mode Lang J 90:536–556CrossRef

17.

Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37–46CrossRef

18.

Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33:363–374PubMedCrossRef

19.

Ito Z, Harada A, Matsui Y, Takemura M, Wakao N, Suzuki T, Nihashi T, Kawatsu S, Shimokata H, Ishiguro N (2006) Can you diagnose for vertebral fracture correctly by plain X-ray? Osteoporos Int 17:1584–1591PubMedCrossRef

20.

Binkley N, Krueger D, Gangnon R, Genant HK, Drezner MK (2005) Lateral vertebral assessment: a valuable technique to detect clinically significant vertebral fractures. Osteoporos Int 16:1513–1518PubMedCrossRef

21.

Link TM, Guglielmi G, van Kuijk C, Adams JE (2005) Radiologic assessment of osteoporotic vertebral fractures: diagnostic and prognostic implications. Eur Radiol 15:1521–1532PubMedCrossRef

22.

Nakano T, Abe Y, Shimizu Y, Ochi R, Seike I, Iwamoto K, Fujiwara K, Takagi K (1999) Rate of correct diagnosis for vertebral fracture by plain roentgenograms (in Japanese). Fracture 21:586–588

23.

Kanchiku T, Taguchi T, Kawai S (2003) Magnetic resonance imaging diagnosis and new classification of the osteoporotic vertebral fracture. J Orthop Sci 8:463–466PubMedCrossRef

24.

Paggiosi MA, Finigan J, Peel N, Eastell R, Ferrar L (2012) Supine vs decubitus lateral patient positioning in vertebral fracture assessment. J Clin Densitom 15:454–460PubMedCrossRef

25.

Sanfélix-Genovés J, Arana E, Sanfélix-Gimeno G, Peiró S, Graells-Ferrer M, Vega-Martínez M (2012) Agreement between semi-automatic radiographic morphometry and Genant semi-quantitative method in the assessment of vertebral fractures. Osteoporos Int 23:2129–2134PubMedCrossRef

Title: Efficacy of the dynamic radiographs for diagnosing acute osteoporotic vertebral fractures
Authors: R. Niimi
T. Kono
A. Nishihara
M. Hasegawa
A. Matsumine
T. Kono
A. Sudo
Publication date: 01-02-2014
Publisher: Springer London
Published in: Osteoporosis International / Issue 2/2014
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-013-2456-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Efficacy of the dynamic radiographs for diagnosing acute osteoporotic vertebral fractures

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2014

Sclerostin serum levels in prostate cancer patients and their relationship with sex steroids

Alendronate and risk of lower limb ischemic vascular events: a population-based cohort study

The associations between QCT-based vertebral bone measurements and prevalent vertebral fractures depend on the spinal locations of both bone measurement and fracture

Molecular alterations of bone quality in sequesters of bisphosphonates-related osteonecrosis of the jaws

Reference values of bone mineral density and prevalence of osteoporosis in Chinese adults

Bone and mineral metabolism in patients undergoing Roux-en-Y gastric bypass