Niimi R, Kono T, Nishihara A, Hasegawa M, Matsumine A, Kono T, Sudo A
Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi, Mie, 510-8008, Japan,
Osteoporos Int. 2014 Feb;25(2):605-12. doi: 10.1007/s00198-013-2456-9. Epub 2013 Aug 1.
We investigated the efficacy of dynamic radiographs for diagnosing acute osteoporotic vertebral fractures (OVFs) compared with supine radiographs or sitting radiographs alone. Evaluation of the dynamic radiographs was superior to the other evaluations. Dynamic radiographs provide a convenient and useful method of diagnosing acute OVFs.
Identifying acute OVFs on plain radiographs is difficult. We studied a new approach to identify acute OVFs on the basis of fracture mobility.
We performed a retrospective radiographic analysis of 472 acute OVFs (<3 weeks after onset), which were diagnosed on the basis of magnetic resonance imaging of T5 through L5 (a total of 5,239 vertebrae). Supine lateral radiographs were compared with sitting lateral radiographs to determine the presence or absence of mobility. Vertebrae showing changes in the vertebral body height were diagnosed as acute OVFs. We analyzed the diagnostic accuracy on the basis of comparative supine and sitting lateral radiographs and compared it with that of radiographs obtained in the supine or the sitting position alone.
Of the 472 acute OVFs diagnosed, 313 (66 %) exhibited vertebral mobility on supine lateral and sitting lateral radiographs. Correct diagnoses of acute OVFs or no acute OVFs were made in 4,883 vertebrae. There were 159 unreadable OVFs (3 %), and 197 previous OVFs (4 %) were misdiagnosed as acute OVFs. The sensitivity was 66 % and the specificity was 96 %. Evaluation of the mobility of acute OVFs in the supine and the sitting position was superior to evaluation using radiographs in either the supine or the sitting position alone.
Dynamic radiographs provide a convenient way to identify acute OVFs.
我们研究了动态X线片与单纯仰卧位X线片或坐位X线片相比，在诊断急性骨质疏松性椎体骨折（OVF）方面的疗效。动态X线片的评估优于其他评估。动态X线片为诊断急性OVF提供了一种方便且有用的方法。
在普通X线片上识别急性OVF很困难。我们研究了一种基于骨折活动度来识别急性OVF的新方法。
我们对472例急性OVF（发病后<3周）进行了回顾性X线分析，这些病例是根据T5至L5的磁共振成像（共5239个椎体）诊断的。比较仰卧位侧位X线片和坐位侧位X线片以确定是否存在活动度。椎体高度有变化的椎体被诊断为急性OVF。我们基于仰卧位和坐位侧位X线片的比较分析了诊断准确性，并将其与单独在仰卧位或坐位获得的X线片的诊断准确性进行比较。
在诊断的472例急性OVF中，313例（66%）在仰卧位侧位和坐位侧位X线片上表现出椎体活动度。在4883个椎体中对急性OVF或无急性OVF做出了正确诊断。有159例OVF无法解读（3%），197例既往OVF（4%）被误诊为急性OVF。敏感性为66%，特异性为96%。仰卧位和坐位时急性OVF活动度的评估优于单独使用仰卧位或坐位X线片的评估。
动态X线片为识别急性OVF提供了一种方便的方法。
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