Purpose
Osteoporotic vertebral fractures are often left unreported during routine radiological examination worldwide.
After an initial osteoporotic vertebral body fracture the subsequent risk for another fracture during the 1st year is 25%.
Early identification can lead to prevention of other serious fractures.
Studies have shown that up to two thirds of vertebral fractures do not come to clinical attention.
It is thought they are missed on routine radiology due to their low profile.Studies have concluded that 32% of false negatives were due to ambiguous terminology.
An...
Methods and Materials
The local PACS and Radiology Information System (RIS) were used to conduct a retrospective review of CT studies performed on patients over the age of 60 who had the whole body scans performed,
for unrelated indications,
over a 7 month period.
The reporting of a fracture and description was assessed from the retrieved radiology reports.
A prospective review was subsequently carried out a year after the results were discussed at a regional audit meeting,
which highlighted the importance of reporting osteoporotic vertebral body fractures and...
Results
400 cases were collected on the initial audit and 200 in the current audit.
A total of 56 (28%) vertebral body fractures were identified in the current audit (previously 33%).
Since the previous audit only 38% of fractures were documented on the radiology report (previously 42%).
Of the unreported fractures 63% were Grade 1 (previously 61%),
Grade 2,
26% (previously 27%) and Grade 3,
11% (previously 12%).
Of the fractures reported 57% were reported using standard terminology (previously 82%).
Conclusion
Overall fewer osteoporotic vertebral body fractures were reported.
The majority of these were grade 1 fractures.
There was an improvement in reporting of higher grade fractures.
To help improve reporting we suggest simplifying fracture description by using the term “vertebral body fracture” during initial reporting and avoid ambiguity.
We will also discuss possible reasons for under reporting,
including not performing 2D reconstructions.
Radiology should play a pivotal role in this process,
as adequate treatment regimens are available.
References
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Berger...