Skip to main content
Erschienen in: Osteoporosis International 8/2009

01.08.2009 | Original Article

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

verfasst von: J. C. Netelenbos, W. F. Lems, P. P. Geusens, H. J. Verhaar, A. J. M. Boermans, M. M. Boomsma, P. G. H. Mulder, S. E. Papapoulos

Erschienen in: Osteoporosis International | Ausgabe 8/2009

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Anon (2002) America’s bone health: the state of osteoporosis and low bone mass in our nation. National Osteoporosis Foundation, Washington (DC) Anon (2002) America’s bone health: the state of osteoporosis and low bone mass in our nation. National Osteoporosis Foundation, Washington (DC)
4.
Zurück zum Zitat Hofman A, Boerlage PA, Bots ML et al (1995) Prevalence of chronic diseases in the elderly; the ERGO study (Erasmus Rotterdam Health and the Elderly). Ned Tijdschr Geneeskd 139(39):1975–1978PubMed Hofman A, Boerlage PA, Bots ML et al (1995) Prevalence of chronic diseases in the elderly; the ERGO study (Erasmus Rotterdam Health and the Elderly). Ned Tijdschr Geneeskd 139(39):1975–1978PubMed
5.
Zurück zum Zitat Geusens PP, Lems WF, Verhaar HJ et al (2006) Review and evaluation of the Dutch guidelines for osteoporosis. J Eval Clin Pract 12(5):539–548PubMedCrossRef Geusens PP, Lems WF, Verhaar HJ et al (2006) Review and evaluation of the Dutch guidelines for osteoporosis. J Eval Clin Pract 12(5):539–548PubMedCrossRef
6.
Zurück zum Zitat Kaptoge S, Armbrecht G, Felsenberg D et al (2006) Whom to treat? The contribution of veretebral X-rays to risk-based algorithms for fracture prediction: results from the European Prospective Osteoporosis Study. Osteoporos Int 17(9):1369–1381PubMedCrossRef Kaptoge S, Armbrecht G, Felsenberg D et al (2006) Whom to treat? The contribution of veretebral X-rays to risk-based algorithms for fracture prediction: results from the European Prospective Osteoporosis Study. Osteoporos Int 17(9):1369–1381PubMedCrossRef
8.
Zurück zum Zitat Genant HK, Li J, Wu CY, Shepherd JA (2000) Vertebral fractures in osteoporosis: a new method for clinical assessment. J Clin Densitometry 3(3):281–290CrossRef Genant HK, Li J, Wu CY, Shepherd JA (2000) Vertebral fractures in osteoporosis: a new method for clinical assessment. J Clin Densitometry 3(3):281–290CrossRef
9.
Zurück zum Zitat Siris ES, Miller PD, Barrett-Connor E et al (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286(22):2815–2822PubMedCrossRef Siris ES, Miller PD, Barrett-Connor E et al (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286(22):2815–2822PubMedCrossRef
10.
Zurück zum Zitat Miller PD, Siris ES, Barrett-Connor E et al (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17(12):2222–2230PubMedCrossRef Miller PD, Siris ES, Barrett-Connor E et al (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17(12):2222–2230PubMedCrossRef
11.
Zurück zum Zitat Schuit SC, van der Klift M, Weel AE et al (2004) Fracture incidence and association with bone mineral density in elderly men and women. The Rotterdam Study. Bone 34(1):195–202CrossRef Schuit SC, van der Klift M, Weel AE et al (2004) Fracture incidence and association with bone mineral density in elderly men and women. The Rotterdam Study. Bone 34(1):195–202CrossRef
12.
Zurück zum Zitat Sornay-Rendu E, Munoz F, Garnero P Duboeuf F, Delmas PD (2005) Identification of Osteopenic Women at High Risk of Fracture: The OFELY Study. J Bone Miner Res 20(10):1813–1819PubMedCrossRef Sornay-Rendu E, Munoz F, Garnero P Duboeuf F, Delmas PD (2005) Identification of Osteopenic Women at High Risk of Fracture: The OFELY Study. J Bone Miner Res 20(10):1813–1819PubMedCrossRef
13.
Zurück zum Zitat Siris ES, Genant HK, Laster AJ et al (2007) Enhanced prediction of fracture risk combining vertebral fracture status and BMD. Osteoporos Int 18(6):761–777PubMedCrossRef Siris ES, Genant HK, Laster AJ et al (2007) Enhanced prediction of fracture risk combining vertebral fracture status and BMD. Osteoporos Int 18(6):761–777PubMedCrossRef
14.
Zurück zum Zitat 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(5):821–828PubMedCrossRef 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(5):821–828PubMedCrossRef
15.
Zurück zum Zitat Ismail AA, Cockerill W, Cooper C et al (2001) Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int 12(2):85–90PubMedCrossRef Ismail AA, Cockerill W, Cooper C et al (2001) Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int 12(2):85–90PubMedCrossRef
16.
Zurück zum Zitat Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–39PubMedCrossRef Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–39PubMedCrossRef
17.
Zurück zum Zitat Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382PubMedCrossRef Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382PubMedCrossRef
18.
19.
Zurück zum Zitat Kanis JA, Johnell O, Oden A et al (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397PubMedCrossRef Kanis JA, Johnell O, Oden A et al (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397PubMedCrossRef
20.
Zurück zum Zitat Khosla S, Melton LJ III (2007) Clinical practice. Osteopenia. N Engl J Med 356(22):2293–2300PubMedCrossRef Khosla S, Melton LJ III (2007) Clinical practice. Osteopenia. N Engl J Med 356(22):2293–2300PubMedCrossRef
21.
Zurück zum Zitat Chapurlat RD, Duboeuf F, Marion-Audibert HO et al (2006) Effectiveness of instant vertebral assessment to detect prevalent vertebral fracture. Osteoporosis Int 17(8):1189–1195CrossRef Chapurlat RD, Duboeuf F, Marion-Audibert HO et al (2006) Effectiveness of instant vertebral assessment to detect prevalent vertebral fracture. Osteoporosis Int 17(8):1189–1195CrossRef
22.
Zurück zum Zitat Vosse D, Heijckmann C, Landewé R et al (2007) Comparing morphometric X-ray absorptiometry and radiography in defining vertebral wedge fractures in patients with ankylosing spondylitis. Rheumatology (Oxford) 46(11):1667–1671CrossRef Vosse D, Heijckmann C, Landewé R et al (2007) Comparing morphometric X-ray absorptiometry and radiography in defining vertebral wedge fractures in patients with ankylosing spondylitis. Rheumatology (Oxford) 46(11):1667–1671CrossRef
Metadaten
Titel
Spine radiographs to improve the identification of women at high risk for fractures
verfasst von
J. C. Netelenbos
W. F. Lems
P. P. Geusens
H. J. Verhaar
A. J. M. Boermans
M. M. Boomsma
P. G. H. Mulder
S. E. Papapoulos
Publikationsdatum
01.08.2009
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 8/2009
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0801-1

Weitere Artikel der Ausgabe 8/2009

Osteoporosis International 8/2009 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.