[Correlation of bone mineral density with lumbago and vertebral fracture in climacteric women].
Lumbago is considered to be an important clinical symptom of involutional osteoporosis, and is designated by the Ministry of Health and Welfare of Japan as one of the principal symptoms included in the criteria for the diagnosis of that condition. A study was designed to investigate the relationship between bone mineral density (BMD) and lumbago, as well as between BMD and vertebral compressive fractures in climacteric women. The study included a total of 400 outpatients (aged 49.2 +/- 0.4 years) visiting our department. The degree of lumbago was evaluated on the basis of an oral questionnaire. BMD was measured simultaneously by X-ray of the thoracic and lumbar vertebrae, the MD/MS and DXA. The presence or absence of vertebral fracture was judged on the X-ray image. As a result, there was seen to be no relation between lumbago and BMD. BMD was found to be significantly (p < 0.01) lower in 15 subjects with compressive fracture at thoracic and/or lumbar levels as judged on X-ray image than in subjects without fractures (n = 328). The above results suggested that, rather than considering lumbago as an important clinical symptom, the exact measurement of BMD and assessment of fracture in accordance with the definition of osteoporosis is the first step in diagnosing this disease. The upper limit of the fracture threshold determined from L2-4 BMD in these 15 subjects was 0.982 g/cm2. Of the subjects without fractures, 48.3% were found to have L2-4 BMD values at this level or lower, suggesting that they are at high risk of future fracture.(ABSTRACT TRUNCATED AT 250 WORDS)
Makita
K
K
Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo.
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D002979:Climacteric; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis; D016103:Spinal Fractures / Q000503:physiopathology*