Vertebral fracture is the most common fragility fracture and is a hallmark of osteoporosis. These fractures frequently occur in the elderly. The incidence of new vertebral fracture in women and men aged 50 years and over was 10.7/1000 person years and 5.7/1000 person years respectively in Europe [
1]. Clinical vertebral fractures were estimated to be 1.4 million around the world in 2000 [
2]. 520,000 new vertebral fractures were sustained in the 27 countries of the European Union (EU27) in 2010 [
3].The incidence of vertebral fracture markedly increases with age in both female and male. The prevalence of vertebral fracture increased from 3% in women below 60 years of age to 20% in women aged over 70 yrs. and from 7.5 to 20% in men over the same age range [
4]. The incidence rate of new vertebral fracture in Chinese men and women aged 50 and above was 194/100,000 person-years and 508/100,000 person-years respectively in Hong Kong [
5]. In Beijing of China, the prevalence of vertebral fracture increased from 15% in women aged over 50 years to 36.6% in women aged over 80 yrs. [
6]. Osteoporotic vertebral fracture is a marker of reduced bone strength and the presence of existing vertebral fracture increases the risk of new fractures and death. The accurate diagnosis of vertebral fractures is important for the treatment of osteoporosis and prevention of new fractures. Because many vertebral fractures are asymptomatic or cause mild pain, the majority of vertebral fractures are not diagnosed worldwide [
7]. Vertebral fractures need radiological confirmation but are often undiagnosed by radiologists, with a misdiagnosis rate up to 50% [
8]. In this study, we examined the prevalence of moderate and severe vertebral fractures on the chest radiographs of hospitalized patients and determined missed diagnosis of vertebral fractures in the original radiology reports.