title: What Proportion of Incident Radiographic Vertebral Fractures in Older Men Is Clinically Diagnosed and Vice Versa: A Prospective Study.
abstract: To determine the proportion of incident radiographic vertebral fractures (vfx) also diagnosed as incident clinical vfx in older men and vice-versa, we used data from 4398 community-dwelling men age ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study. Incident radiographic vfx were identified by comparing baseline and follow-up lateral thoracic and lumbar spine study films (average 4.6 years between films) using a semiquantitative (SQ) method and defined as a change in SQ reading of ≥1 at a given vertebral level from baseline to follow-up study radiograph. Participants were contacted triannually to ascertain incident clinical vfx; community spinal imaging studies were obtained and clinical vfx were confirmed when the study radiologist determined that the community imaging study showed a new deformity of higher grade than was present in the same vertebra on the baseline study radiograph. A total of 237 incident radiographic vfx were identified in 197 men, whereas 31 men experienced 37 confirmed incident clinical vfx. Of incident radiographic vfx, 13.5% were also clinically diagnosed as incident fractures, with clinical diagnoses made for 16.3% of the radiographic vfx with SQ grade change ≥2. Of incident clinical vfx, 86.5% were identified as incident radiographic vfx, most of them with SQ grade change ≥2. In summary, less than 15% of incident radiographic vfx were also clinically diagnosed, whereas the majority of incident clinical vfx were identified as severe radiographic vfx. These results in men supplement those previously published for women and suggest a complex relationship between clinical and radiographic vfx in older adults. Published 2016.(†) American Society for Bone and Mineral Research.
authors.affiliation: Department of Medicine, School of Public Health, University of Minnesota, Minneapolis, MN, USA.|Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.|Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.
authors.forename: Terri L
authors.initials: TL
authors.lastname: Blackwell
authors.affiliation: Department of Medicine, School of Public Health, University of Minnesota, Minneapolis, MN, USA.|Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.|Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.|Geriatric Research Education & Clinical Center, VA Health Care System, Minneapolis, MN, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Fink
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, USA.|Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Black
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.affiliation: Deparment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Curtis
authors.affiliation: Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kado
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Marshall
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
authors.affiliation: Park Nicollet Clinic, St. Louis Park, MN, USA.|Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
mesh_terms: D000368:Aged; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology
keywords: CLINICAL DIAGNOSIS; OLDER MEN; RADIOGRAPHS; VERTEBRAL FRACTURES