title: The Prevalence of Undetected Vertebral Fracture in Patients with Back Pain by Dual-Energy X-ray Absorptiometry (DXA) of the Lateral Thoracic and Lumbar Spine.
abstract: METHODS
  This is a prospective study.
  
  
  OBJECTIVE
  This study is conducted to determine the prevalence of unrecognized vertebral fracture (VF) in patients who present with back pain.
  
  
  BACKGROUND
  VF is often unrecognized, and significantly increases the risk of further fractures. Unfortunately, the patients at a high risk for VF usually do not receive adequate therapy to reduce the fracture risk.
  
  
  METHODS
  This is a prospective study of 344 patients who presented with back pain from April 2008 to May 2009. The patients underwent dual-energy X-ray absorptiometry (DXA) evaluation and vertebral fracture assessment from T4 to L4 using a hologic densitometer.
  
  
  RESULTS
  Three hundred forty four of 386 patients who presented with back pain were included. Forty two patients were excluded because of a prior history of VF or the lack of written consent. Most of the patients were female (95.3%). The mean age of the patients was 58.21 ± 11.74 years. According to the World Health Organization definition (based on the T-score), 13.4% of the patients had normal lumbar spine bone mineral density (BMD). 27.9% of them were osteopenic and 58.7% were osteoporotic. The overall prevalence of VF, as established by lateral vertebral assessment, was 39% (n = 134). Moreover, 62.6% (n = 84) of the patients with VF had more than one fracture and 64.1% (n = 86) of them had Grade 2 or 3 fracture.
  
  
  CONCLUSIONS
  We recommend performing not only DXA scanning for BMD evaluation, but also VFA by DXA in old patients with back pain.
authors: Department of Radiology, Valie-asr Hospital, Birjand University of Medical Sciences, Birjand, Iran.
authors: Ali Reza
authors: AR
authors: Ehsanbakhsh
authors: Hadi
authors: H
authors: Akhbari
authors: Morteza Bahri
authors: MB
authors: Iraee
authors: Farokh Sailanian
authors: FS
authors: Toosi
authors: Nasrin
authors: N
authors: Khorashadizadeh
authors: Mohammad Reza
authors: MR
authors: Rezvani
authors: Ghodratollah
authors: G
authors: Naseh