Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 282-289 |
| Number of pages | 8 |
| Journal | Journal of Bone & Mineral Research |
| Volume | 34 |
| Issue number | 2 |
| Early online date | 5 Nov 2018 |
| DOIs | |
| Publication status | Published - Feb 2019 |
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Adding Lateral Spine Imaging for Vertebral Fractures to Densitometric Screening: Improving Ascertainment of Patients at High Risk of Incident Osteoporotic Fractures. / Prince, Richard; Lewis, Joshua; Lim, W.H.; Wong, Germaine; Wilson, Kevin E.; Khoo, Benjamin; Zhu, Kun; Kiel, Douglas P.; Schousboe, John T.
In: Journal of Bone & Mineral Research, Vol. 34, No. 2, 02.2019, p. 282-289.Research output: Contribution to journal › Article
TY - JOUR
T1 - Adding Lateral Spine Imaging for Vertebral Fractures to Densitometric Screening: Improving Ascertainment of Patients at High Risk of Incident Osteoporotic Fractures
AU - Prince, Richard
AU - Lewis, Joshua
AU - Lim, W.H.
AU - Wong, Germaine
AU - Wilson, Kevin E.
AU - Khoo, Benjamin
AU - Zhu, Kun
AU - Kiel, Douglas P.
AU - Schousboe, John T.
PY - 2019/2
Y1 - 2019/2
N2 - The current diagnosis of osteoporosis is limited to a T‐score ≤–2.5. However, asymptomatic vertebral fractures (VF) are known to predict a high risk of subsequent fractures and pharmaceutical intervention is known to reduce future fracture risk in these individuals. In a prospective, population‐based cohort of ambulant older women, we sought to evaluate the role of VF detection by screening densitometric lateral spine imaging (LSI) for VF at time of bone density testing to the effect on the magnitude of fracture risk. A total of 1084 women (mean age 75 years ± SD 3 years) had baseline LSI that identified 100 (9%) women with VFs and 89 (8%) with femoral neck (FN) T‐score osteoporosis ≤–2.5. Follow‐up identified incident clinical spine fracture in 73 (7%), 305 (28%) with any fracture‐related hospitalization, and 121 (11%) with a hip fracture–related hospitalization. Compared with those without baseline VF, in those with baseline VF, relative risk (RR) for incident clinical spine, hip, and any fracture were 3.46 (95% confidence interval [CI] 2.14–5.60, p < 0.001); 1.72 (95% CI 1.09–2.71, p = 0.02), and 1.4 (95% CI 1.07–1.84, p = 0.02), respectively. In 675 (62%) of women with femoral neck osteopenia (T‐score <–1 to >–2.5), 61 (9%) also had a VF. Compared with those without baseline VF, RR for any incident fragility fractures and fractures at spine and hip in those with baseline VF were 1.6 (95% CI 1.2–2.1, p < 0.01), 3.9 (95% CI 2.2–6.9, p < 0.01), and 1.6 (95% CI 0.9–2.8, p = 0.10), respectively. On basis of the prognosis, older women with LSI VF with osteopenia should be diagnosed with osteoporosis and should be considered for pharmaceutical intervention. © 2018 American Society for Bone and Mineral Research.
AB - The current diagnosis of osteoporosis is limited to a T‐score ≤–2.5. However, asymptomatic vertebral fractures (VF) are known to predict a high risk of subsequent fractures and pharmaceutical intervention is known to reduce future fracture risk in these individuals. In a prospective, population‐based cohort of ambulant older women, we sought to evaluate the role of VF detection by screening densitometric lateral spine imaging (LSI) for VF at time of bone density testing to the effect on the magnitude of fracture risk. A total of 1084 women (mean age 75 years ± SD 3 years) had baseline LSI that identified 100 (9%) women with VFs and 89 (8%) with femoral neck (FN) T‐score osteoporosis ≤–2.5. Follow‐up identified incident clinical spine fracture in 73 (7%), 305 (28%) with any fracture‐related hospitalization, and 121 (11%) with a hip fracture–related hospitalization. Compared with those without baseline VF, in those with baseline VF, relative risk (RR) for incident clinical spine, hip, and any fracture were 3.46 (95% confidence interval [CI] 2.14–5.60, p < 0.001); 1.72 (95% CI 1.09–2.71, p = 0.02), and 1.4 (95% CI 1.07–1.84, p = 0.02), respectively. In 675 (62%) of women with femoral neck osteopenia (T‐score <–1 to >–2.5), 61 (9%) also had a VF. Compared with those without baseline VF, RR for any incident fragility fractures and fractures at spine and hip in those with baseline VF were 1.6 (95% CI 1.2–2.1, p < 0.01), 3.9 (95% CI 2.2–6.9, p < 0.01), and 1.6 (95% CI 0.9–2.8, p = 0.10), respectively. On basis of the prognosis, older women with LSI VF with osteopenia should be diagnosed with osteoporosis and should be considered for pharmaceutical intervention. © 2018 American Society for Bone and Mineral Research.
U2 - 10.1002/jbmr.3595
DO - 10.1002/jbmr.3595
M3 - Article
VL - 34
SP - 282
EP - 289
JO - Journal of Bone & Mineral Research
JF - Journal of Bone & Mineral Research
SN - 0884-0431
IS - 2
ER -