Combined Vertebral Fracture Assessment and Bone Mineral Density Measurement: A Patient-friendly New Tool with an Important Impact on the Canadian Risk Fracture Classification
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
Purpose Vertebral fractures often go unnoticed, while they constitute a significant risk factor for new fractures, independent of the bone density. Vertebral Fracture Assessment (VFA) is a new feature on DXA bone densitometry equipment. Our purpose was to determine the added value of VFA and its impact on the Canadian fracture risk classification using data from a Dutch academic cohort. Methods All 958 consecutive patients (64% female, mean age 53 [20–94], mean weight 75 kg [32–150]) who underwent BMD measurement at the University Medical Center Groningen, The Netherlands also underwent VFA in the same session. Results The prevalence of vertebral fractures was 26%. In 68% of these patients this fracture was unknown. The severity was “mild” (20%–25% height loss) in 43%, “moderate” (25%–35%) in 44% and “severe” (>35% height loss) in 13%. Even after excluding mild fractures, the prevalence of vertebral fractures was 17%. In the 28% with normal BMD the vertebral fracture prevalence was still 18%, in the 43% with osteopenia 23%, and in the 29% with osteoporosis 36%. The Canadian risk classification was “low fracture risk” in 68%, “moderate” in 19%, and “high” in 13%. Adding VFA altered the classification in 20% of the patients, to become 54%, 27%, and 19%, respectively. Conclusions VFA added to BMD is a patient friendly diagnostic tool with a high diagnostic yield, as it detected unknown vertebral fractures and altered diagnostic classification in approximately 1 out of every 5 patients. These results suggest that BMD plus VFA may become the new standard in osteoporosis testing.
