H C van der Jagt-Willems1, B C van Munster2, M Leeflang3, E Beuerle4, C R Tulner5, W F Lems6. 1. Department of Geriatrics, Slotervaart Hospital, Amsterdam, The Netherlands; Department of Internal Medicine, Spaarne Hospital, Hoofddorp, The Netherlands. Electronic address: Hvanderjagt@spaarneziekenhuis.nl. 2. Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands. 3. Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands. 4. Department of Radiology, Slotervaart Hospital, Amsterdam, The Netherlands. 5. Department of Geriatrics, Slotervaart Hospital, Amsterdam, The Netherlands. 6. Department of Rheumatology, VU Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: In clinical practice lateral images of the chest are performed for various reasons. As these lateral chest X rays show the vertebrae of the thoracic and thoraco-lumbar region, we wondered if these X-rays can be used for evaluation of vertebral fractures instead of separate thoracic spine X-rays. METHODS: To evaluate the agreement and intraobserver reliability of the semi-quantitative method for vertebral fractures on the lateral chest X-ray (X-chest) in comparison to the lateral thoracic spine X-ray (X-Tspine), two observers scored vertebral fractures on X-Tspine and twice on X-chest, separately,blinded and in different time periods. Agreement and Cohens' kappa were calculated for a diagnosis of any fracture on patient level and on vertebral body level. The study was done in patients visiting an outpatient geriatric day clinic, with a high prevalence of vertebral fractures. RESULTS: 109 patients were included. The intraobserver agreement for X-chest versus X-Tspine was 95-98%for the two levels of fracturing, with a Cohen's kappa of 0.88-0.91. The intraobserver agreement and reliability of the re-test on the X-chest showed an agreement between 91 and 98% with a Cohen's kappa of 0.81-0.93. More vertebrae were visible on the X-chest, mean 10.2, SD 0.66 versus mean 9.8, SD 0.73 on the X-Tspine (p < 0.001). CONCLUSION: The results show good agreement and intraobserver reliability on the X-chest compared to the X-Tspine for visualizing vertebral fractures. The results of this study emphasizes that the routinely performed X-chest is reliable in order to diagnose vertebral fractures.
BACKGROUND: In clinical practice lateral images of the chest are performed for various reasons. As these lateral chest X rays show the vertebrae of the thoracic and thoraco-lumbar region, we wondered if these X-rays can be used for evaluation of vertebral fractures instead of separate thoracic spine X-rays. METHODS: To evaluate the agreement and intraobserver reliability of the semi-quantitative method for vertebral fractures on the lateral chest X-ray (X-chest) in comparison to the lateral thoracic spine X-ray (X-Tspine), two observers scored vertebral fractures on X-Tspine and twice on X-chest, separately,blinded and in different time periods. Agreement and Cohens' kappa were calculated for a diagnosis of any fracture on patient level and on vertebral body level. The study was done in patients visiting an outpatient geriatric day clinic, with a high prevalence of vertebral fractures. RESULTS: 109 patients were included. The intraobserver agreement for X-chest versus X-Tspine was 95-98%for the two levels of fracturing, with a Cohen's kappa of 0.88-0.91. The intraobserver agreement and reliability of the re-test on the X-chest showed an agreement between 91 and 98% with a Cohen's kappa of 0.81-0.93. More vertebrae were visible on the X-chest, mean 10.2, SD 0.66 versus mean 9.8, SD 0.73 on the X-Tspine (p < 0.001). CONCLUSION: The results show good agreement and intraobserver reliability on the X-chest compared to the X-Tspine for visualizing vertebral fractures. The results of this study emphasizes that the routinely performed X-chest is reliable in order to diagnose vertebral fractures.
Authors: Hanna C van der Jagt-Willems; Maartje H de Groot; Jos P C M van Campen; Claudine J C Lamoth; Willem F Lems Journal: BMC Geriatr Date: 2015-03-28 Impact factor: 3.921
Authors: T T Jansz; N A Goto; A J van Ballegooijen; H C Willems; M C Verhaar; B C van Jaarsveld Journal: Osteoporos Int Date: 2019-11-14 Impact factor: 4.507