Vertebral fractures are independent risk factors for both vertebral and peripheral fractures and only one-third of these fractures come to clinical attention. Vertebral fracture assessment (VIA) is a radiographic method using dual X-ray absorptiometry (DXA) to assess vertebral deformities during bone density measurement. We performed VFA of the spine from T4 to L5 on a Delphi W device (Hologic, Bedford, MA) in 136 postmenopausal patients (69 +/- 10 yr). These patients also had X-rays of the thoracic and lumbar spine. VIA was independently compared with X-rays by two rheumatologists, for the diagnosis of vertebral fractures at both the patient and vertebral levels. Using X-rays, 61 patients (45%) had at least one vertebral fracture. The percentage of unreadable vertebrae was 1% and 12.4% on X-rays and VFA, respectively (p < 0.0001). At the patient level, VIA allowed to diagnose if the patient had no fracture or had at least one fracture in 74% of patients. In 11.2% of cases, VFA misclassified the patients. At the vertebral level, diagnostic efficacy of VFA as compared with X-rays was 97%. Concordance between both observers was good (kappa-score = 0.69). We designed an algorithm for decision of performing X-rays in postmenopausal women: Using results of VFA would avoid X-rays in 32% of our patients. VFA is a reliable technique with low radiation, and is easily and rapidly applicable during bone density measurement by DXA, which could improve management of osteoporotic patients.
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Black, DM
Arden, NK
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Arden, NK
Palermo, L
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Palermo, L
Pearson, J
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Pearson, J
Cummings, SR
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Ferrar, L
Jiang, G
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Jiang, G
Eastell, R
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Eastell, R
Peel, NFA
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
Ferrar, L
Jiang, G
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
Jiang, G
Eastell, R
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
机构:
Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Genant, HK
Li, J
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Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Li, J
Wu, CY
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Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Wu, CY
Shepherd, JA
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Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
机构:
Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Black, DM
Arden, NK
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h-index: 0
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Arden, NK
Palermo, L
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Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Palermo, L
Pearson, J
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h-index: 0
机构:
Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
Pearson, J
Cummings, SR
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h-index: 0
机构:
Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA
机构:
Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Ferrar, L
Jiang, G
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Jiang, G
Eastell, R
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h-index: 0
机构:
Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
Eastell, R
Peel, NFA
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h-index: 0
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield, S Yorkshire, England
机构:
Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
Ferrar, L
Jiang, G
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h-index: 0
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
Jiang, G
Eastell, R
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h-index: 0
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Univ Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, EnglandUniv Sheffield, Div Clin Sci, Med Sect, Bone Metab Grp, Sheffield S10 2TN, S Yorkshire, England
机构:
Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Genant, HK
Li, J
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h-index: 0
机构:
Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Li, J
Wu, CY
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机构:
Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA
Wu, CY
Shepherd, JA
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Univ Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Radiol, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA