title: An efficient case finding strategy to diagnose osteoporosis in a developing society with low treatment frequency.
abstract: OBJECTIVE
  Osteoporosis is a debilitating condition with rising frequency of fragility fractures with advancing age. Life expectancy increases in developing societies with the emergence of osteoporosis. There is a need for a simple protocol to diagnose fractures that merit treatment for osteoporosis.
  
  
  METHODS
  Evaluation of all consecutive lateral chest radiographs performed at the National Hospital in the capital city in Greenland over a 3-month period for vertebral body heights at the anterior, middle and posterior regions. Use of anti-osteoporotic drug was evaluated from records of dispensed drugs from Greenland National Pharmacy.
  
  
  RESULTS
  1869 vertebrae were evaluated on radiographs from 203 subjects. On average 9.2 vertebrae (range 5-13) qualified for evaluation in each individual. Median (range) age was 55 (30-82) years. Any vertebral deformity above 25 (20) % was seen in 28.6 (50.2) %. More than one fracture was seen in 10.3 (27.1) %. Fractures occurred in 18.5 (36.9) % of patients from the General Medicine Clinic and in 33.3 (56.5) % of inpatients (p = 0.029). The occurrence of vertebral fractures increased with age (p < 0.001) and hosting more than one vertebral fracture was markedly more frequent after the age of 60 years [OR, 95 % CI 9.6, 3.1-30 (5.7, 2.9-11); p < 0.001] after correction for gender in logistic regressions. The National Pharmacy handed out anti-osteoporotic drugs equal to the treatment of 36 individuals.
  
  
  CONCLUSIONS
  Vertebral fractures that merit treatment can be readily diagnosed from lateral chest radiographs taken in routine clinical work-up. They are common in Greenland as demonstrated by this simple protocol to improve diagnosis and treatment of osteoporosis in a developing society.
authors.affiliation: Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland.
authors.forename: Vibeke Neergaard
authors.initials: VN
authors.lastname: Sørensen
authors.forename: Piotr
authors.initials: P
authors.lastname: Wojtek
authors.forename: Dorthe S
authors.initials: DS
authors.lastname: Pedersen
authors.forename: Stig
authors.initials: S
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006116:Greenland / Q000208:ethnology; D006801:Humans; D004930:Inuit / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000208:ethnology* / Q000628:therapy; D013902:Radiography, Thoracic / Q000379:methods; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000208:ethnology* / Q000628:therapy; D044465:White People / Q000208:ethnology*