title: Vertebral deformities identified by vertebral fracture assessment: associations with clinical characteristics and bone mineral density.
abstract: Whether vertebral fractures identified on radiographs are painful or not, they are associated with increased morbidity and mortality. Vertebral fractures on X-rays correlate with low bone mineral density (BMD) at the spine and hip in addition to several clinical characteristics. Evidence suggests that vertebral deformities detected by X-ray and by vertebral fracture assessment (VFA) show good agreement. We examined the relationship between VFA-detected vertebral deformities and patient characteristics as well as BMD by analyzing the records of 432 patients who had undergone dual-energy X-ray absorptiometry (DXA) scans with VFA. Patients' demographic data and T-scores were obtained from patient questionnaires and DXA scans. We categorized vertebral deformities by type and severity. Patients with vertebral deformities were significantly older and more likely to report a history of fracture after childhood. Significantly more estrogen use was reported in patients without deformity. Those with deformities had significantly lower T-scores at the femoral neck and total hip but not at the spine. Increased severity and number of deformities correlated with lower T-scores at the total hip and femoral neck but not the spine. In conclusion, vertebral deformities detected by VFA, like those on X-ray, correlate with both clinical characteristics and reduced bone mass at the hip. These relationships, in addition to rapid performance, convenience, and minimal radiation exposure, indicate VFA-detected vertebral deformities are a valuable adjunct in identifying patients in need of additional evaluation and treatment.
authors.affiliation: Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Jacobs-Kosmin
authors.forename: Nora
authors.initials: N
authors.lastname: Sandorfi
authors.forename: Heather
authors.initials: H
authors.lastname: Murray
authors.forename: John L
authors.initials: JL
authors.lastname: Abruzzo
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D010024:Osteoporosis / Q000150:complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*