37. Diagnosis and Classification of Vertebral Fracture

  1. Clifford J. Rosen MD
  1. James F. Griffith,
  2. Judith E. Adams and
  3. Harry K. Genant

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch37

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Griffith, J. F., Adams, J. E. and Genant, H. K. (2013) Diagnosis and Classification of Vertebral Fracture, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch37

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • magnetic resonance imaging (MRI);
  • spinal radiography;
  • vertebral fracture assessment (VFA);
  • volumetric quantitative computed tomography (vQCT)

Summary

Vertebral fracture is usually the first osteoporotic fracture to occur and also the most common osteoporotic fracture, being present in 15% of women aged 50-59 years. Despite the clear clinical importance of vertebral fractures, they remain underdiagnosed in clinical practice. Good technique in performing spinal radiographs and a high level of observer experience in image interpretation are key to the reliable diagnosis of vertebral fractures. Vertebral fracture assessment (VFA) is being utilized increasingly for vertebral fracture identification. Density and structural parameters obtained by volumetric quantitative computed tomography (vQCT) can predict vertebral compressive strength ex vivo, and these parameters, together with nonlinear finite element analysis (FEA) can also be applicable in vivo. Magnetic resonance imaging (MRI) can detect minor acute or subacute vertebral fracture or re-fracture, determine fracture age, and distinguish between osteoporotic and neoplastic fracture with greater sensitivity than other imaging techniques.