Usefulness of bone densitometry in postmenopausal women with clinically diagnosed vertebral fractures

• Published in: Annals of the rheumatic diseases Vol. 61; no. 1; pp. 73 - 75
• Main Authors: Nolla, J M, Gómez-Vaquero, C, Fiter, J, Vilaseca, D Roig, Mateo, L, Rozadilla, A, Romera, M, Valverde, J, Escofet, D Roig
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01-01-2002; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Absorptiometry, Photon - standards; Adult; Age; Age Factors; Aged; Aged, 80 and over; Analysis; Analysis of Variance; Back pain; Biological and medical sciences; BMD; Bone densitometry; Bone Density; Bone diseases; bone mineral density; Bones; Causes of; Concise Report; confidence interval; Confidence Intervals; Densitometria òssia; densitometry; Density; Diseases of the osteoarticular system; dual energy x ray absorptiometry; DXA; Female; Fractures; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical prognosis; Medical sciences; Menopausa; Menopause; Metabolism; Middle Aged; MRPO; Multicentre Research Project on Osteoporosis; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis, Postmenopausal - diagnostic imaging; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Population; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Rheumatology; Spinal Fractures - diagnostic imaging; Spinal Fractures - physiopathology; Spine; Trauma; Vertebrae; vertebral fracture; Womens health; Spain; Human; Lumbar spine; Indication; Diseases of the osteoarticular system; Radiologic investigation; Vertebra; Bone disease; Fracture; Spine disease; Trauma; Density; Epidemiology; Incidence; Osteoporosis; X ray absorption spectrometry; Postmenopause; Female; Bone; Elderly; Public health
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.61.1.73

Objective: To analyse whether bone mineral density (BMD) assessment is required in postmenopausal women presenting with low trauma vertebral fracture. Methods: Women with vertebral fracture diagnosed over a 10 year period were recruited from our database. The following were excluded: (a) patients with high energy trauma; (b) patients with malignancies; (c) patients with a metabolic bone disease other than osteoporosis. All postmenopausal women were included in whom BMD had been evaluated at both the lumbar spine and femoral neck by dual energy x ray absorptiometry during the six months after the diagnosis. Patients with a potential cause of osteoporosis other than age and menopause were not considered. A total of 215 patients were identified. Results: The mean (SD) age of the patients was 65.9 (6.9) years. BMD at the lumbar spine was 0.725 (0.128) g/cm2 and the T score was −2.94 (1.22); BMD at the femoral neck was 0.598 (0.095) g/cm2 and the T score was −2.22 (0.89). The BMD of the patients was significantly lower than that of the general population at both the lumbar spine and femoral neck. When the lowest value of the two analysed zones was considered, six patients (3%) showed a normal BMD, 51 (23.5%) osteopenia, and 158 (73.5%) osteoporosis. The prevalence of osteoporosis at the femoral neck increased with age; it was 25% in patients under 60, 35% in patients aged 60–70, and 60% in patients over 70. Conclusion: These results indicate that bone densitometry is not required in postmenopausal women with clinically diagnosed vertebral fractures if it is performed only to confirm the existence of a low BMD.