Spine radiographs to improve the identification of women at high risk for fractures.
CONCLUSIONS
In women older than 60 years with clinical risk factors for osteoporosis but without osteoporosis based on bone mineral density (T-score >or= -2.5), a systematic survey with X-rays of the spine identified previously unknown vertebral deformities in 21% of women.


BACKGROUND
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 >or= -2.5).


METHODS
Bisphosphonate naïve women older than 60 years attending 35 general practices in the Netherlands with >or=2 clinical risk factors for osteoporosis were invited for BMD measurement (DXA). In women with T-score >or= -2.5 at both spine and the hips, lateral radiographs of the thoracic and lumbar spine were performed.


RESULTS
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 >or= -2.5 at both spine and hip, 387 had additional spine radiographs, of whom 80 (21%) had at least one vertebral deformity.


CONCLUSIONS
In elderly women with clinical risk factors for osteoporosis but BMD T-score >or= -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.
Netelenbos
J C
JC
Department of Endocrinology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands. c.netelen@vumc.nl
Lems
W F
WF
Geusens
P P
PP
Verhaar
H J
HJ
Boermans
A J M
AJ
Boomsma
M M
MM
Mulder
P G H
PG
Papapoulos
S E
SE
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors; D013121:Spinal Curvatures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology