Michael A Kelly1, Eva McCabe2, Diane Bergin3, Stephen R Kearns4, John P McCabe4, Catherine Armstrong5, Fiona Heaney5, John J Carey6. 1. Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Ireland. 2. Department of Rheumatology, Galway University Hospitals, Ireland; School of Medicine, National University of Ireland, Galway, Ireland. Electronic address: eva.mccabe@nuigalway.ie. 3. Department of Radiology, Galway University Hospitals, Ireland. 4. Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Ireland; School of Medicine, National University of Ireland, Galway, Ireland. 5. Department of Rheumatology, Galway University Hospitals, Ireland. 6. Department of Rheumatology, Galway University Hospitals, Ireland; School of Medicine, National University of Ireland, Galway, Ireland.
Abstract
INTRODUCTION: The vertebrae are the most common site for osteoporotic fracture. While they can result in disability and increased mortality, only one-third present clinically. People with multiple fractures are at greater risk of future fractures. Most hip fracture patients are neither diagnosed nor treated for their underlying osteoporosis. Computed tomography (CT) studies are often performed on hospitalised patients, can be used to diagnose osteoporosis and are gaining popularity for opportunistic osteoporosis screening by measuring BMD and other bone strength indices. The aim of this study was to assess the prevalence of vertebral fractures on CT pulmonary angiograms (CTPA) in a cohort of hip fracture patients and whether this increased their diagnosis and treatment rates. METHODS: We retrospectively identified all hip fractures admitted to our institution between 2010 and 2017 to identify those who underwent CTPA scans. An independent, blinded consultant musculoskeletal radiologist reviewed the images for vertebral fractures and quantified severity using Genant criteria. Results were compared to the original radiology report, discharge diagnoses and treatment rates for osteoporosis. RESULTS: Eleven percent (225/2122) of patients had CTPA images available. Seventy percent (158) were female with a mean age of 78 years (SD: 11). The median length of stay for all patients was 16 days (1-301). Forty percent (90) of patients had at least one vertebral fracture present and 20% (46) had more than one fracture. Only one in 5 radiology reports noted the fractures. 24% of subjects had osteoporosis treatment recorded at hospital discharge and there was no difference between those with vertebral fractures to those without. CONCLUSION: Many hip fracture patients have undiagnosed spine fractures. A screening strategy which evaluates CT scans for fractures has potential to increase diagnosis and treatment rates of osteoporosis. However, more work is needed to increase awareness.
INTRODUCTION: The vertebrae are the most common site for osteoporotic fracture. While they can result in disability and increased mortality, only one-third present clinically. People with multiple fractures are at greater risk of future fractures. Most hip fracturepatients are neither diagnosed nor treated for their underlying osteoporosis. Computed tomography (CT) studies are often performed on hospitalised patients, can be used to diagnose osteoporosis and are gaining popularity for opportunistic osteoporosis screening by measuring BMD and other bone strength indices. The aim of this study was to assess the prevalence of vertebral fractures on CT pulmonary angiograms (CTPA) in a cohort of hip fracturepatients and whether this increased their diagnosis and treatment rates. METHODS: We retrospectively identified all hip fractures admitted to our institution between 2010 and 2017 to identify those who underwent CTPA scans. An independent, blinded consultant musculoskeletal radiologist reviewed the images for vertebral fractures and quantified severity using Genant criteria. Results were compared to the original radiology report, discharge diagnoses and treatment rates for osteoporosis. RESULTS: Eleven percent (225/2122) of patients had CTPA images available. Seventy percent (158) were female with a mean age of 78 years (SD: 11). The median length of stay for all patients was 16 days (1-301). Forty percent (90) of patients had at least one vertebral fracture present and 20% (46) had more than one fracture. Only one in 5 radiology reports noted the fractures. 24% of subjects had osteoporosis treatment recorded at hospital discharge and there was no difference between those with vertebral fractures to those without. CONCLUSION: Many hip fracturepatients have undiagnosed spine fractures. A screening strategy which evaluates CT scans for fractures has potential to increase diagnosis and treatment rates of osteoporosis. However, more work is needed to increase awareness.
Authors: Małgorzata Dziedzic; Mariola Janiszewska; Małgorzata Goździewska; Wioleta Kowalska; Jacek Roliński Journal: Int J Environ Res Public Health Date: 2022-09-27 Impact factor: 4.614
Authors: John J Carey; Lan Yang; E Erjiang; Tingyan Wang; Kelly Gorham; Rebecca Egan; Attracta Brennan; Mary Dempsey; Catherine Armstrong; Fiona Heaney; Eva McCabe; Ming Yu Journal: Calcif Tissue Int Date: 2021-06-03 Impact factor: 4.333