Vertebral Fracture Assessment by Dual X-Ray Absorptiometry: A Valid Tool to Detect Vertebral Fractures in Community-Dwelling Older Adults in a Population-Based Survey

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP DOMICIANO, Diogo S. FMUSP-HC
LOPES, Jaqueline B. FMUSP-HC
dc.identifier.citation ARTHRITIS CARE & RESEARCH, v.65, n.5, p.809-815, 2013
dc.identifier.issn 2151-464X
dc.description.abstract Objective Vertebral fractures are associated with higher morbidity and mortality. Since 70% of vertebral fractures are clinically silent, a radiologic image of the spine has to be acquired for the diagnosis. The aim of this study was to compare the performance of Vertebral Fracture Assessment (VFA) by dual x-ray absorptiometry (DXA) with radiographs to identify vertebral fractures in community-dwelling older adults. Methods A total of 429 older adults (ages 65 years) were enrolled in this cohort. VFA by DXA measurements were evaluated by 2 expert rheumatologists by consensus, and spine radiographs were analyzed according to the semiquantitative method by an expert radiologist. The correlation between VFA and spine radiographs to identify vertebral fractures was analyzed by kappa scores. Results The prevalence of vertebral fractures in VFA and radiographs was 29.1% and 29.4%, respectively (P = 0.99). The frequency of unavailable vertebrae was significantly lower in spinal radiographs than in VFA (0.9% and 5.6%, respectively; P < 0.001), particularly in T4T6. According to VFA, 5,013 vertebrae (96%) were identified as normal and 144 (2.7%) had grade 1, 58 (1.1%) had grade 2, and 12 (0.2%) had grade 3 fractures. The sensitivity of VFA was 72.9% and the specificity was 99.1% to identify vertebral fractures. The sensitivity increased to 92% and the specificity increased to 99.9% when excluding grade 1 deformities. A good correlation between VFA and radiographs ( = 0.74) was observed, and the exclusion of grade 1 resulted in even better agreement ( = 0.84). Conclusion In community-dwelling older adults, VFA and radiographs had comparable performances in identifying vertebral fractures, particularly if mild deformities are excluded. Therefore, this methodology is a feasible and promising alternative to improve the management of patients with a high risk of osteoporotic fractures.
dc.description.sponsorship · FAPESP [03/09313-0]
· Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
· Federico Foundation
· CNPq [300559/2009-7]
dc.language.iso eng
dc.publisher WILEY-BLACKWELL
dc.relation.ispartof Arthritis Care & Research
dc.rights restrictedAccess
dc.subject.other morphometric radiography; postmenopausal women; osteoporosis; deformities; risk; men; densitometry; mortality; spine; osteoarthritis
dc.title Vertebral Fracture Assessment by Dual X-Ray Absorptiometry: A Valid Tool to Detect Vertebral Fractures in Community-Dwelling Older Adults in a Population-Based Survey
dc.type article
dc.rights.holder Copyright WILEY-BLACKWELL LIM/23 LIM/17
dc.identifier.doi 10.1002/acr.21905
dc.identifier.pmid 23212896
dc.type.category original article
dc.type.version publishedVersion DOMICIANO, Diogo S.:FM: LOPES, Jaqueline B.:FM: TAKAYAMA, Liliam:FM:MCM CAPARBO, Valeria F.:FM:MCM FULLER, Priscila:HC:ICHC SCAZUFCA, Marcia:HC:LIM/23 BONFA, Eloisa:FM:MCM PEREIRA, Rosa M. R.:FM:MCM · FIGUEIREDO, Camille P.:Univ Sao Paulo, BR-01246903 Sao Paulo, Brazil
· KUROISHI, Marcia E.:Univ Sao Paulo, BR-01246903 Sao Paulo, Brazil
· MENEZES, Paulo F.:Univ Sao Paulo, BR-01246903 Sao Paulo, Brazil 2-s2.0-84876744634 WOS:000318114700019 HOBOKEN USA
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dc.description.index MEDLINE
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hcfmusp.citation.wos 18 Brasil

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