Radiographic methods for evaluating osteoporotic vertebral fractures.

INSERM, ERI12, Faculté de Médecine et de Pharmacie, 1 rue des Louvels 80037 Amiens, France; Service de Rhumatologie, Hôpital Nord, CHU Amiens, 80 054 Amiens Cedex 1, France.
Joint, bone, spine: revue du rhumatisme (Impact Factor: 2.25). 03/2009; 76(3):241-7. DOI: 10.1016/j.jbspin.2008.07.017
Source: PubMed

ABSTRACT Reproducible methods for the radiological assessment of osteoporotic vertebral fractures, defined based on accurate criteria, are needed in everyday practice and in therapeutic trials and epidemiological studies.
To describe and to evaluate methods for osteoporotic vertebral fracture assessment based on standard radiographs or dual-energy X-ray absorptiometry (DXA) and to determine the role for each method in clinical practice, therapeutic trials, and epidemiological studies.
A review written by a rheumatologist based on his clinical experience and on a literature review was submitted to four experts. Studies in English or French published between 1975 and February 2008 were retrieved from Medline using the keywords vertebral fracture, osteoporosis, vertebral deformity, and vertebral fracture assessment.
One hundred forty-nine articles were selected and read in their full-text version. There was no consensus regarding the definition of osteoporotic vertebral fractures. The following methods were evaluated: visual assessment, Genant's semi-quantitative assessment, Jiang's algorithm-based qualitative method, morphometric radiography, and DXA of the spine. In everyday practice, Genant's semi-quantitative assessment on standard radiographs may provide useful information on the severity and prognosis of osteoporosis. DXA done for bone mineral density measurement may detect vertebral fractures in asymptomatic patients. Assessment of standard radiographs remains the reference standard for diagnosing vertebral fractures in patients with suggestive symptoms (e.g., pain in the thoracic or lumbar spine, height loss, or thoracic kyphosis). For therapeutic trials and epidemiological studies, Genant's semi-quantitative assessment used by a trained and experienced observer is the preferred method, based on its good reproducibility and ability to differentiate fractures from other deformities. However, thousands of radiographs may be needed, making routine interpretation by an expert impractical. A visual semi-quantitative method may be used to separate normal radiographs from radiographs showing possible or obvious fractures, which can then be read by an expert. Alternatively, radiomorphometric indices can be determined on digitized radiographs in combination with a semi-quantitative assessment, with discordant cases being reviewed by an expert. We do not recommend Jiang's method at present, as it is still undergoing validation.

  • [Show abstract] [Hide abstract]
    ABSTRACT: (Lateral) chest X-ray's are often performed in older individuals for various reasons.•Vertebral fractures are visualized on lateral chest X-ray, but the diagnosis of vertebral fractures is until now only validated on (lateral) spine X-ray's.•This study shows that a (lateral) chest X-ray is sufficient for the diagnosis of vertebral fractures.•Older individuals with a vertebral fracture on a (lateral) chest X-ray do not need further radiography with thoracic spine X-ray or vertebral fracture assessment with DXA.
    European Journal of Radiology 12/2014; 83. · 2.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Population-based studies performed with vertebral fracture assessment (VFA) morphometric technology are lacking in postmenopausal osteoporosis. In this study, we show a lower than expected prevalence of vertebral fractures, a high prevalence of minor vertebral deformities, and a clear association with clinical and densitometric parameters indicating the usefulness of this approach. Adequate epidemiological data on the prevalence of vertebral fractures (VF) is essential in studies of postmenopausal osteoporosis. Routine DXA-assisted VFA may be useful to determine the presence of VF. However, population-based studies performed with this technology are lacking. We aimed to assess the prevalence of VF and minor deformities in 2,968 postmenopausal women aged 59-70 years from a population-based cohort. VFA and bone mineral density (BMD) measurements were conducted, and McCloskey criteria (vertebral heights under 3 SD from reference values) confirmed with the Genant method were used to define VF. Additionally, minor vertebral deformities (vertebral heights between -2 and -2.99 SD) were evaluated. The prevalence of VF was 4.3 %, and 17 % of the participants had minor vertebral deformities. Low BMD was frequently observed in women with VF, with 48 %, and 42 % of participants showing osteoporosis and osteopenia. Minor vertebral deformities were observed in nearly 40 % of women with VF. Multivariate logistic regression analysis showed that age, history of previous fracture, osteoporotic BMD, receiving anti-osteoporotic treatment, and current use of glucocorticoids were significantly associated with VF. Although the VFA approach showed a lower than expected prevalence of VF in our cohort, its association with clinical and densitometric parameters may be useful to identify women at risk for developing fragility fractures and may therefore justify its use in longitudinal studies. The high prevalence of minor vertebral deformities detected in patients with VF indicates the need to evaluate this type of deformity as a risk factor for further skeletal fractures.
    Osteoporosis International 03/2014; · 4.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We present a new high-resolution M-channel, 2-dimensional lattice linear prediction parameter estimation method. The Yule-Walker like equations are formulated, consisting of a nested block matrix structure. The linear prediction parameters are estimated using a Levinson type recursion based on lattice (reflection coefficient) technique. The linear prediction parameters are then used in a companion M-channel, 2-dimensional autoregressive spectral estimator. The output of this technique is sharpened auto-spectral image from the two channels, and super resolved cross-spectral images that preserves what is in common between the two channels. This technique is well suited for Ultrawide-band processing, high-resolution multichannel data fusion and clutter suppression. In the simulation section, we compare two channels with 4 point like sources each, 2 or which are common between the two 2-D channels, and show that sharpened results of the 2 common sources in the combined image.
    Signals, Systems and Computers, 2004. Conference Record of the Thirty-Seventh Asilomar Conference on; 01/2003

Full-text (2 Sources)

Available from
Dec 2, 2014