University of Bristol, Southmead Hospital, Bristol BS10 5NB, UK.
Rheumatology (Oxford). 2010 Mar;49(3):505-12. doi: 10.1093/rheumatology/kep414. Epub 2009 Dec 16.
Vertebral fractures (VFs) are frequently under-recognized, reflecting their lack of diagnostic clinical features. For example, although VFs are associated with back pain, this is also common in the general population. To establish whether back pain can be used to recognize patients with VF, we investigated the site of pain in people with and without VFs using a simple tool.
A cohort of 504 post-menopausal women was recruited from primary care in South West UK. Back pain was assessed by self-completion of the Margolis pain diagram, and analysis was modified to assess whether pain was mid-line or lateral. VFs were diagnosed by the algorithm-based qualitative method on radiographs. A cross-sectional analysis was carried out to assess the association between back pain and VFs.
Three hundred and twenty-two women (64.1%) reported back pain over the last 12 months. Thirty seven (7.3%) had one or more VFs. In women with back pain, the presence of lateral waist area pain was associated with a 4.5-fold increased risk of VFs [odds ratio (OR) 4.48; 95% CI 2.02, 9.94; P < 0.001].
In post-menopausal women with back pain, the presence of lateral waist pain, as shown on the Margolis pain diagram, may identify women at higher risk of prevalent VF.
椎体骨折（VF）经常被漏诊，这反映出其缺乏明确的临床诊断特征。例如，尽管 VF 与背痛有关，但这种情况在普通人群中也很常见。为了确定背痛是否可用于识别患有 VF 的患者，我们使用一种简单的工具研究了有和没有 VF 的患者的疼痛部位。
从英国西南部的初级保健中招募了 504 名绝经后妇女组成队列。通过自行完成 Margolis 疼痛图来评估背痛，并对分析进行修改以评估疼痛是否位于中线或侧面。通过基于算法的定性方法在 X 光片上诊断 VF。进行横断面分析以评估背痛与 VF 之间的关联。
322 名女性（64.1%）报告在过去 12 个月内有背痛。37 名女性（7.3%）有一个或多个 VF。在有背痛的女性中，腰部侧面疼痛的存在与 VF 的风险增加 4.5 倍相关[比值比（OR）4.48；95%置信区间 2.02，9.94；P <0.001]。
在有背痛的绝经后妇女中，Margolis 疼痛图上显示的腰部侧面疼痛的存在可能会识别出患有常见 VF 的风险更高的女性。
