Osteoporotic Vertebral Fractures Underreported

Osteoporotic vertebral fractures are often under reported by radiologists, particularly non-musculoskeletal radiologists.

Osteoporotic vertebral fractures may be under reported, resulting in delayed treatment for osteoporosis, according to a study published in Archives of Osteoporosis.

Researchers from the United Kingdom performed a retrospective cohort study to investigate the reporting and follow-up of vertebral fragility fractures (VFFs) by radiologists at their facility. Patients with osteoporotic VFFs are at increased risk of future fractures, including hip fractures.

The researchers used data from 732 patients presenting with a hip fracture, all of whom were over age 50. The researchers identified patients who had also undergone a radiological procedure that included the thoracic and/or lumbar spine in the previous six years.

The results showed 157 patients had previously undergone a radiological procedure involving the spine and VFFs were identified in 65 of the 157 (41%). Among these 65 patients, only 30 (46%) were reported by a radiologist when the fracture was first visible. Thirty-two of the remaining 35 patients (91%) who had unreported VFFs were from imaging reported by non-musculoskeletal radiologists. Only 16 of the 65 of patients (25%) with a VFF were documented as being on bone-specific therapy at the time of hip fracture.

"It is essential that radiologists are vigilant for the presence of VFFs on routine imaging, particularly in older patients,” co-author Ruth M. Mitchell at the University of Oxford said in a release. “Equally important is having an effective referral system in place to ensure these patients, once identified, are directed to fracture prevention services. We believe that together this will increase the number of patients receiving effective osteoporosis therapy, protecting against future hip fractures and the associated mortality, morbidity and cost."