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.

Additional Metadata
Keywords Bone mineral density, Case finding, Dual-energy X-ray absorptiometry, Spine radiographs
Persistent URL dx.doi.org/10.1007/s00198-008-0801-1, hdl.handle.net/1765/14159
Citation
Netelenbos, J.C., Lems, W.F., Geusens, P.P., Verhaar, H.J., Boermans, A.J.M., Boomsma, M.M., … Papapoulos, S.E.. (2008). Spine radiographs to improve the identification of women at high risk for fractures. Osteoporosis International: with other metabolic bone diseases, 20(8), 1347–1352. doi:10.1007/s00198-008-0801-1