Identifying interventions with Gypsies, Roma and Travellers to promote immunisation uptake: methodological approach and
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Identifying osteoporotic vertebral fracture James F. Griffith Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China Correspondence to: Prof. James F. Griffith. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China. Email: [email protected].
Abstract: Osteoporosis per se is not a harmful disease. It is the sequela of osteoporosis and most particularly the occurrence of osteoporotic fracture that makes osteoporosis a serious medical condition. All of the preventative measures, investigations, treatment and research into osteoporosis have one primary goal and that is to prevent the occurrence of osteoporotic fracture. Vertebral fracture is by far and away the most prevalent osteoporotic fracture. The significance and diagnosis of vertebral fracture are discussed in this article. Keywords: Vertebral fracture; osteoporosis; metastases; radiography; computed tomography (CT); magnetic resonance imaging (MRI) Submitted Jul 20, 2015. Accepted for publication Jul 31, 2015. doi: 10.3978/j.issn.2223-4292.2015.08.01 View this article at: http://dx.doi.org/10.3978/j.issn.2223-4292.2015.08.01
Why is it important to diagnose osteoporotic vertebral fractures? Diagnosing an osteoporotic vertebral fracture is important in that it provides: (I) A source for the patient’s symptoms; (II) A marker of reduced bone strength; (III) A predictor of further osteoporotic fracture. Patient’s symptoms As back pain is common in elderly patients, most vertebral fractures go unrecognized clinically with symptoms attributed to degenerative change. This is particularly so as osteoporotic vertebral fractures classically occur during normal day-to-day activities such as bending, walking or lifting relatively light objects. Three-quarter of patients with vertebral fracture do not seek medical attention (1) and even up to 2/3 of vertebral fractures may not result in notably severe symptoms (2). Clinical assessment of vertebral fractures is generally poor and reliance is made on imaging studies for diagnosis. In addition to pain, osteoporotic vertebral fractures result in immobility with its accompanying problems of chest infection, muscle loss, inability to cope with daily activities © Quantitative Imaging in Medicine and Surgery. All rights reserved.
and social isolation (3). Multiple vertebral fractures can result in loss of height, exaggerated thoracic kyphosis, poor self-image and loss of self esteem. As well as increased morbidity, increased mortality is also associated with vertebral fracture. For example, subjects with incident fracture have a 3-fold increased mortality risk over the ensuring 4 years compared to non-fractured counterparts, particularly due to pulmonary disease and cancer (4). Marker of reduced bone strength The presence of an osteoporotic or insufficiency fracture is the ultimate marker of reduced bone strength, overriding all other
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