scholarly journals Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism

2015 ◽  
Vol 172 (2) ◽  
pp. 189-194 ◽  
Author(s):  
Ana Paula Barbosa ◽  
Mário Rui Mascarenhas ◽  
Carlos Francisco Silva ◽  
Isabel Távora ◽  
Manuel Bicho ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Young Men ◽  
Whole Body ◽  
Vertebral Fracture Assessment ◽  
Mineral Density ◽  
X Ray ◽  
Fracture Assessment ◽  
The Mean ◽  
And Control

BackgroundHyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure.ObjectivesThis study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism.DesignWe conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups.Materials and methodsA group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm2) at L1–L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used.ResultsThe mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures.ConclusionsThe results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment.

Diagnosis of vertebral fractures on lateral chest X-ray: Intraobserver agreement of semi-quantitative vertebral fracture assessment

2014 ◽  
Vol 83 (12) ◽  
pp. 2177-2180 ◽  
Author(s):  
H.C. van der Jagt-Willems ◽  
B.C. van Munster ◽  
M. Leeflang ◽  
E. Beuerle ◽  
C.R. Tulner ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Vertebral Fracture Assessment ◽  
Intraobserver Agreement ◽  
X Ray ◽  
Chest X Ray ◽  
Fracture Assessment ◽  
Lateral Chest

scholarly journals Combined Vertebral Fracture Assessment and Bone Mineral Density Measurement: A Patient-friendly New Tool with an Important Impact on the Canadian Risk Fracture Classification

2010 ◽  
Vol 61 (4) ◽  
pp. 194-200 ◽  
Author(s):  
Pieter L. Jager ◽  
Riemer H.J.A. Slart ◽  
Colin L. Webber ◽  
Jonathan D. Adachi ◽  
Alexandra L. Papaioannou ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Fracture Risk ◽  
Vertebral Fractures ◽  
Density Measurement ◽  
Significant Risk ◽  
Risk Classification ◽  
Vertebral Fracture Assessment ◽  
Height Loss ◽  
Mineral Density ◽  
Fracture Assessment

Purpose Vertebral fractures often go unnoticed, while they constitute a significant risk factor for new fractures, independent of the bone density. Vertebral Fracture Assessment (VFA) is a new feature on DXA bone densitometry equipment. Our purpose was to determine the added value of VFA and its impact on the Canadian fracture risk classification using data from a Dutch academic cohort. Methods All 958 consecutive patients (64% female, mean age 53 [20–94], mean weight 75 kg [32–150]) who underwent BMD measurement at the University Medical Center Groningen, The Netherlands also underwent VFA in the same session. Results The prevalence of vertebral fractures was 26%. In 68% of these patients this fracture was unknown. The severity was “mild” (20%–25% height loss) in 43%, “moderate” (25%–35%) in 44% and “severe” (>35% height loss) in 13%. Even after excluding mild fractures, the prevalence of vertebral fractures was 17%. In the 28% with normal BMD the vertebral fracture prevalence was still 18%, in the 43% with osteopenia 23%, and in the 29% with osteoporosis 36%. The Canadian risk classification was “low fracture risk” in 68%, “moderate” in 19%, and “high” in 13%. Adding VFA altered the classification in 20% of the patients, to become 54%, 27%, and 19%, respectively. Conclusions VFA added to BMD is a patient friendly diagnostic tool with a high diagnostic yield, as it detected unknown vertebral fractures and altered diagnostic classification in approximately 1 out of every 5 patients. These results suggest that BMD plus VFA may become the new standard in osteoporosis testing.

scholarly journals POS1110 RELIABILITY OF VERTEBRAL FRACTURE ASSESSMENT ON DUAL-ENERGY X-RAY ABSORPTIOMETRY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 835.2-835
Author(s):  
M. Yasmine ◽  
S. Mariem ◽  
S. Miladi ◽  
A. Fazaa ◽  
E. Fguiri ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Bone Mineral ◽  
Vertebral Fracture Assessment ◽  
Mineral Density ◽  
Vertebral Height ◽  
Rater Reliability ◽  
X Ray ◽  
Normal Bone Mineral Density ◽  
Fracture Assessment ◽  
Grade 3

Background:Vertebral Fracture Assessment (VFA) is a new feature available on modern densitometers. Yet, the assessment of vertebral fracture (VF) status has not become standard practice.Objectives:Our study aimed to evaluate the reliability of VFA as assessed by a rheumatologist and a radiology technician.Methods:We conducted a cross-sectional study assessing the performance of low-radiation single energy x-ray absorptiometry VFA for the detection of VF. We selected patients who were assessed for osteoporosis according to screening protocols. Bone mineral densitometry was measured using standard methods over the lumbar spine L1-L4, the total proximal femur, and results were expressed as T-scores. All VFA were independently evaluated by 2 experienced readers: a rheumatologist and a radiology technician for the identification of VF (T4-L4). VF was classified according to the Genant grading system: grade 1 for an anterior, mid or posterior reduction of 20–25% in vertebral height; grade 2 for a reduction of 25– 40% and grade 3 for a reduction of more than 40% in vertebral height. A score for the inter-rater reliability between the readers was expressed using the kappa statistic.Results:One hundred patients were included with a mean age of 66.9 ± 9.5 years [46.7-83] years. There was a female predominance (91%). Nearly half of patients had osteopenia (48.9%), 27.7% had osteoporosis and 23.4% had a normal bone mineral density. On VFA scans, the non-visible vertebra was mostly located in the upper thoracic spine (60%). The mean number of VF was 1.2 [0-3] for both readers. According to the doctor’s evaluation, 25% of patients had at least one VF, of which 75.9% had a Genant grade 1, 17.2% had a Genant 2, and 6.9% had a VF grade 3. According to the technician evaluation, at least one VF was found in 36% of patients. A grade 1 was assessed in 91.7% of cases, a grade 2 in 8.3% of patients but no VF grade 3 was assessed. A kappa score for the inter-rater reliability between the readers for VFA was 0.545 (p=0.000). The overall agreement by grade between the readers was 0.785 (p=0,000). The exclusion of non-visible vertebra resulted in a better agreement (k=0.853). Further analysis excluding vertebra T4 to D10, revealed a very good agreement (k=0.9).Conclusion:Our study showed a low agreement between the readers on VFA and a better agreement when non-visible vertebrae were excluded. Thus, caution should be advocated when relying exclusively on this device.Disclosure of Interests:None declared.

scholarly journals AB0614 DENSITOMETRIC VERTEBRAL FRACTURE ASSESSMENT: FACTORS LIMITING GOOD VISIBILITY OF THE VERTEBRA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1342.2-1342
Author(s):  
S. Mariem ◽  
M. Yasmine ◽  
S. Miladi ◽  
A. Fazaa ◽  
E. Frigui ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Vertebral Fracture ◽  
The Elderly ◽  
Vertebral Fracture Assessment ◽  
Mineral Density ◽  
Vertebral Osteoporosis ◽  
Cross Sectional ◽  
Fracture Assessment ◽  
The Mean ◽  
Good Visibility

Background:The radiograph of the spine is the gold standard for identifying vertebral fractures (VF). Vertebral Fracture Assessment (VFA) is a new feature available on modern densitometers that could assess VF. This technique offers the advantage of low irradiation over standard radiography but at the cost of lower image quality.Objectives:The aim of this study was to assess factors associated with good vertebra visibility when using VFA.Methods:This is a cross-sectional study including patients referred by their physicians for bone mineral density (BMD) measurement. Anthropometric data were recorded. BMD was measured using standard methods over the lumbar spine L1-L4, the total proximal femur. Results were expressed as T-scores using Dual-energy X-ray absorptiometry (DEXA). The screening for VF was performed by VFA. A professional operator analyses VFA scans and assessed the good visibility of the vertebra.Results:The study included 100 patients. The mean age was 61.7 ±12.6 years [18-83].The average body mass index (BMI) was 28.9 ± 24.2 kg/m2 [14.2-45.3]. The mean T-score at the vertebral site was -1.5 DS [-4.9-1.5] with a mean mass of 0.95g/cm2 [0.58-1.371]. Osteoporosis was found in 27.7 % of patients. A vertebral fracture was diagnosed in 25% of cases. The visualization of the vertebra was impaired in the upper thoracic region in 60% of cases. Poor visibility was observed in 19% of cases in the mid-thoracic spine and only in 2% of cases in the lumbar spine. No statistically significant correlation was found between good vertebral visibility and age (p=0.2), weight (p=0.5), or BMI (p=0.7). However, good visibility of the vertebra was associated with a lower height (1.7 m vs 1.5 m, p=0.03). A better vertebrae visualization was correlated neither to the BMD of the right hip (0.84 vs 0.87, p=0.4) nor to the left hip (0.85 vs 0.89, p= 0.3). Similarly, the absence of vertebral osteoporosis was not correlated with a better vertebral visualization (p=0.6).Conclusion:Visibility of the vertebra on VFA does not appear to be altered by the BMD and vertebral osteoporosis, suggesting safe use in the elderly. However, precautions may be taken when interpreting VFA in patients with high heights.Disclosure of Interests:None declared.

Radiographic Vertebral Fracture Assessment of Vertebral Fracture by the Three-Line Method

2021 ◽  
Vol 11 (8) ◽  
pp. 2086-2090
Author(s):  
Nan-Zhi Hu ◽  
Shu-Meng Huang ◽  
Yi-Ren Xu ◽  
Ting Liu ◽  
Bai-Wen Hu ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Quantitative Method ◽  
Spinal Fractures ◽  
Vertebral Fracture Assessment ◽  
X Ray ◽  
Quantitative Technique ◽  
Line Method ◽  
Wilcoxon Rank Sum Test ◽  
Fracture Assessment

Purpose: To evaluate the value of the three-line (TL) method in the diagnosis of vertebral fractures. Methods: 286 patients over 50 years old who received thoracolumbar X-ray examination in our hospital from 2013 to 2019 were selected and divided into three groups according to their age. The incidence and severity of vertebral fractures were measured by the TL method and Genant semi-quantitative technique by the same observer. Eight vertebrae were measured in each patient, ranging from T10 to L5. Results: The TL method was consistent with the Genant semi-quantitative method when evaluating whether patients had vertebral fractures (k >0.75), and the McNemar-bowker test showed no difference in the diagnosis between the two methods (P >0.05). However, Wilcoxon rank sum test found a difference between the two methods in assessing the severity of fractured vertebrae (P < 0.05), and the TL method was more sensitive. Conclusion: The two methods can be substituted for each other in the diagnosis of vertebral fractures. However, TL method is more sensitive in the diagnosis of the severity of spinal fractures. And the TL method is more quantitative and easier for beginners to master.

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