Morning Report

When Vertebral Fractures Are Missed, It's a Lost Chance to Treat Osteoporosis

Arefa Cassoobhoy, MD, MPH


October 13, 2017

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

Missed Vertebral Fractures

Vertebral fractures are common in patients with osteoporosis, and when they occur, the patient is at a higher risk for future fractures.

A recent study[1] evaluated 157 patients from the United Kingdom who had spinal imaging within the 5 years before having a hip fracture. About 40% had detectable vertebral fractures on the images, but less than half of those fractures were reported. The non-musculoskeletal radiologists were most likely to miss vertebral fractures on imaging (including x-rays, CTs, and MRIs) done for other reasons.

In another study,[2] of about 4000 older men in the United States, vertebral fractures that were found on imaging, but not clinically diagnosed, were associated with back pain symptoms.

For primary care clinicians, these studies point to missed opportunities to treat folks with osteoporosis and prevent future fractures (like hip fractures), which come with such high morbidity and mortality.

Follow Dr Cassoobhoy on Twitter at @ArefaMD


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