title: Spine radiographs to improve the identification of women at high risk for fractures.
abstract: 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.
authors.affiliation: Department of Endocrinology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands. c.netelen@vumc.nl
authors.forename: J C
authors.initials: JC
authors.lastname: Netelenbos
authors.forename: W F
authors.initials: WF
authors.lastname: Lems
authors.forename: P P
authors.initials: PP
authors.lastname: Geusens
authors.forename: H J
authors.initials: HJ
authors.lastname: Verhaar
authors.forename: A J M
authors.initials: AJ
authors.lastname: Boermans
authors.forename: M M
authors.initials: MM
authors.lastname: Boomsma
authors.forename: P G H
authors.initials: PG
authors.lastname: Mulder
authors.forename: S E
authors.initials: SE
authors.lastname: Papapoulos
mesh_terms: 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