title: Severe osteoporosis: does structural monitoring help?
abstract: Vertebral fractures, the most common osteoporotic fractures, are associated with excess mortality even in the absence of symptoms. Presence of at least one radiological or clinical prevalent vertebral fracture increases the risk of incident vertebral fractures not only in untreated patients, but also in treated patients, as established by studies involving routine radiological monitoring. Therefore, whether structural monitoring is indicated on a routine basis deserves discussion. Height measurement is a basic monitoring tool for detecting new vertebral fractures. However, loss of height is nonspecific. Radiography involves radiation exposure levels and financial costs that are not consistent with use for routine monitoring. Vertebral fracture assessment based on dual-energy X-ray absorptiometry (VFA), in contrast, is an inexpensive method that delivers only low radiation levels. VFA used in conjunction with absorptiometry may be well suited to the monitoring of women with severe osteoporosis.
authors.affiliation: Université Paris-Descartes, Hôpital Cochin, Service de Rhumatologie B, 27 rue du Faubourg Saint-Jacques, Paris, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Leboime
authors.forename: Claire
authors.initials: C
authors.lastname: David
authors.forename: Nadia
authors.initials: N
authors.lastname: Mehsen
authors.forename: Julien
authors.initials: J
authors.lastname: Paccou
authors.forename: Cyrille B
authors.initials: CB
authors.lastname: Confavreux
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D001175:Arthrography; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010024:Osteoporosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013131:Spine / Q000000981:diagnostic imaging