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

In women older than 60 years with clinical risk factors for osteoporosis but without osteoporosis based on bone mineral density (T-score a parts per thousand yenaEuro parts per thousand a'2.5), a systematic survey with X-rays of the spine identified previously unknown vertebral deformities in 21% of women. 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 a parts per thousand yenaEuro parts per thousand a'2.5). Bisphosphonate na < ve women older than 60 years attending 35 general practices in the Netherlands with a parts per thousand yen2 clinical risk factors for osteoporosis were invited for BMD measurement (DXA). In women with T-score a parts per thousand yenaEuro parts per thousand a'2.5 at both spine and the hips, lateral radiographs of the thoracic and lumbar spine were performed. 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 a parts per thousand yenaEuro parts per thousand a'2.5 at both spine and hip, 387 had additional spine radiographs, of whom 80 (21%) had at least one vertebral deformity. In elderly women with clinical risk factors for osteoporosis but BMD T-score a parts per thousand yenaEuro parts per thousand a'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.