title: Efficacy of the dynamic radiographs for diagnosing acute osteoporotic vertebral fractures.
abstract: We investigated the efficacy of dynamic radiographs for diagnosing acute osteoporotic vertebral fractures (OVFs) compared with supine radiographs or sitting radiographs alone. Evaluation of the dynamic radiographs was superior to the other evaluations. Dynamic radiographs provide a convenient and useful method of diagnosing acute OVFs.
  
  
  BACKGROUND
  Identifying acute OVFs on plain radiographs is difficult. We studied a new approach to identify acute OVFs on the basis of fracture mobility.
  
  
  METHODS
  We performed a retrospective radiographic analysis of 472 acute OVFs (<3 weeks after onset), which were diagnosed on the basis of magnetic resonance imaging of T5 through L5 (a total of 5,239 vertebrae). Supine lateral radiographs were compared with sitting lateral radiographs to determine the presence or absence of mobility. Vertebrae showing changes in the vertebral body height were diagnosed as acute OVFs. We analyzed the diagnostic accuracy on the basis of comparative supine and sitting lateral radiographs and compared it with that of radiographs obtained in the supine or the sitting position alone.
  
  
  RESULTS
  Of the 472 acute OVFs diagnosed, 313 (66 %) exhibited vertebral mobility on supine lateral and sitting lateral radiographs. Correct diagnoses of acute OVFs or no acute OVFs were made in 4,883 vertebrae. There were 159 unreadable OVFs (3 %), and 197 previous OVFs (4 %) were misdiagnosed as acute OVFs. The sensitivity was 66 % and the specificity was 96 %. Evaluation of the mobility of acute OVFs in the supine and the sitting position was superior to evaluation using radiographs in either the supine or the sitting position alone.
  
  
  CONCLUSIONS
  Dynamic radiographs provide a convenient way to identify acute OVFs.
authors.affiliation: Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan, furikakefuri@hotmail.co.jp.
authors.forename: R
authors.initials: R
authors.lastname: Niimi
authors.forename: T
authors.initials: T
authors.lastname: Kono
authors.forename: A
authors.initials: A
authors.lastname: Nishihara
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.forename: A
authors.initials: A
authors.lastname: Matsumine
authors.forename: T
authors.initials: T
authors.lastname: Kono
authors.forename: A
authors.initials: A
authors.lastname: Sudo
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009068:Movement / Q000502:physiology; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011187:Posture / Q000502:physiology; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D016683:Supine Position / Q000502:physiology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology
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