Vertebral fractures (VFs) are the most common fractures related to osteoporosis (50%) and represent a hallmark of the disease; these fractures are also associated with increased morbidity, mortality, impaired quality of life for patients and also increased health costs. Although many VFs are clinically silent, it has been shown that they are associated with increased risk for subsequent osteoporotic fractures; moreover, the detection of VFs strongly predicts the future fracture risk independently from bone density criteria. Several techniques were born and developed to identify spine...

Sixty-eight patients were prospectively enrolled in the study (38 males and 30 females; age 58.1±9.6 years old, range 32-83 years). Lateral spine images were obtained with densitometric and radiographic techniques on the same day by an expert technologist. Images of the spine were independently evaluated by three radiologists with different experience (10,5 and3 years)in skeletal imaging. The T4-L4 segment of the spine was the target of our analysis. The designed diagnostic approach was based on VSQ, as described by Genant et al., with complementary morphometric...

Seventy vertebrae (70/884, 7.9%) were excluded from the lesion-based analysis of results, as not evaluable with one or both of the two techniques: 14/70 (20.0%) with radiography, 59/70 (84.3%) with DXA (upper thoracic spine). Out of the 814 verterbrae considered in the analysis, 40 “true” fractures were detected (40/814, 4.9% vertebrae; 25/40, 62.5% mild fractures) in 26 affected patients (38.2% of the 68 studied patients) (Fig. 2, Fig. 3). On a lesion-based analysis DXA sensitivity and specificity were 70.0% and 98.3% showing a good accuracy...

DXA equipments allow a semiquantitative visual inspection of the spine (vertebral fracture assessment – VFA) or, thanks to integrated software component, quantitative morphometric vertebral analysis (morphometric X-ray absorptiometry). Moreover, DXA offers the opportunity to assess in a single sessionwith very low radiation exposure thetwo most clinically relevant and followed markers of bone metabolism, from an imaging point of view: bone mineral density (BMD) and VFs. Therefore scientific attention and emphasis have been addressed to DXA in the last few years. In conclusion our study confirms...

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