Vertebral Fracture Assessment by Dual X-Ray Absorptiometry: A Valid Tool to Detect Vertebral Fractures in Community-Dwelling Older Adults in a Population-Based Survey

被引：37

作者：

Domiciano, Diogo S. ^{[1
]}

Figueiredo, Camille P. ^{[1
]}

Lopes, Jaqueline B. ^{[1
]}

Kuroishi, Marcia E. ^{[1
]}

Takayama, Liliam ^{[1
]}

Caparbo, Valeria F. ^{[1
]}

Fuller, Priscila ^{[1
]}

Menezes, Paulo F. ^{[1
]}

Scazufca, Marcia ^{[1
]}

Bonfa, Eloisa ^{[1
]}

Pereira, Rosa M. R. ^{[1
]}

机构：

[1] Univ Sao Paulo, BR-01246903 Sao Paulo, Brazil

来源：

ARTHRITIS CARE & RESEARCH | 2013年 / 65卷 / 05期

基金：

巴西圣保罗研究基金会;

关键词：

MORPHOMETRIC RADIOGRAPHY; POSTMENOPAUSAL WOMEN; OSTEOPOROSIS; DEFORMITIES; RISK; MEN; DENSITOMETRY; MORTALITY; SPINE; OSTEOARTHRITIS;

D O I：

10.1002/acr.21905

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective Vertebral fractures are associated with higher morbidity and mortality. Since 70% of vertebral fractures are clinically silent, a radiologic image of the spine has to be acquired for the diagnosis. The aim of this study was to compare the performance of Vertebral Fracture Assessment (VFA) by dual x-ray absorptiometry (DXA) with radiographs to identify vertebral fractures in community-dwelling older adults. Methods A total of 429 older adults (ages 65 years) were enrolled in this cohort. VFA by DXA measurements were evaluated by 2 expert rheumatologists by consensus, and spine radiographs were analyzed according to the semiquantitative method by an expert radiologist. The correlation between VFA and spine radiographs to identify vertebral fractures was analyzed by kappa scores. Results The prevalence of vertebral fractures in VFA and radiographs was 29.1% and 29.4%, respectively (P = 0.99). The frequency of unavailable vertebrae was significantly lower in spinal radiographs than in VFA (0.9% and 5.6%, respectively; P < 0.001), particularly in T4T6. According to VFA, 5,013 vertebrae (96%) were identified as normal and 144 (2.7%) had grade 1, 58 (1.1%) had grade 2, and 12 (0.2%) had grade 3 fractures. The sensitivity of VFA was 72.9% and the specificity was 99.1% to identify vertebral fractures. The sensitivity increased to 92% and the specificity increased to 99.9% when excluding grade 1 deformities. A good correlation between VFA and radiographs ( = 0.74) was observed, and the exclusion of grade 1 resulted in even better agreement ( = 0.84). Conclusion In community-dwelling older adults, VFA and radiographs had comparable performances in identifying vertebral fractures, particularly if mild deformities are excluded. Therefore, this methodology is a feasible and promising alternative to improve the management of patients with a high risk of osteoporotic fractures.

引用

页码：809 / 815

页数：7

共 39 条

[1]

[Anonymous], 1998, FED REG, V63, P34320

[2] Lateral vertebral assessment: a valuable technique to detect clinically significant vertebral fractures [J].