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Semin Musculoskelet Radiol 2024; 28(05): 628-640
DOI: 10.1055/s-0044-1788558
Review Article

Radiographic Diagnosis of Osteoporotic Vertebral Fracture in Older Women and Men Based on Statistical Probability

Yì Xiáng J. Wáng 
1   Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Abstract

A radiographic gold standard to distinguish osteoporotic vertebral fractures (VFs) from nonosteoporotic VFs does not exist. Radiographic fracture-shaped vertebral deformity (FSVD) is common among young populations with normal bone strength. FSVD in an older population is called osteoporotic-like vertebral fracture (OLVF) when the FSVD is likely associated with compromised bone strength. For more severe grade deformities or when a vertebra is collapsed, experienced readers can make an osteoporotic VF diagnosis with a high degree of certainty. In milder cases, radiographic osteoporotic VF is often diagnosed based on a high probability rather than an absolute diagnosis. For older women, three nonadjacent minimal grade OLVFs (< 20% height loss), one minimal grade OLVF and one mild OLVF (≥ 20∼25% height loss), or one OLVF with ≥ 25% height loss meets the diagnosis of osteoporosis. For older men, a single OLVF with ≥ 33 to 40% height loss is insufficient to suggest the patient has osteoporosis.

Keywords

osteoporosis - radiograph - vertebral fracture - vertebral deformity - microfracture


Publication History

Article published online:
15 October 2024

© 2024. Thieme. All rights reserved.

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