Ensrud Kristine E, Blackwell Terri L, Fink Howard A, Zhang Jie, Cauley Jane A, Cawthon Peggy M, Black Dennis M, Bauer Douglas C, Curtis Jeffrey R, Orwoll Eric S, Barrett-Connor Elizabeth, Kado Deborah M, Marshall Lynn M, Shikany James M, Schousboe John T
Department of Medicine, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
J Bone Miner Res. 2016 Aug;31(8):1500-3. doi: 10.1002/jbmr.2831. Epub 2016 Apr 4.
To determine the proportion of incident radiographic vertebral fractures (vfx) also diagnosed as incident clinical vfx in older men and vice-versa, we used data from 4398 community-dwelling men age ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study. Incident radiographic vfx were identified by comparing baseline and follow-up lateral thoracic and lumbar spine study films (average 4.6 years between films) using a semiquantitative (SQ) method and defined as a change in SQ reading of ≥1 at a given vertebral level from baseline to follow-up study radiograph. Participants were contacted triannually to ascertain incident clinical vfx; community spinal imaging studies were obtained and clinical vfx were confirmed when the study radiologist determined that the community imaging study showed a new deformity of higher grade than was present in the same vertebra on the baseline study radiograph. A total of 237 incident radiographic vfx were identified in 197 men, whereas 31 men experienced 37 confirmed incident clinical vfx. Of incident radiographic vfx, 13.5% were also clinically diagnosed as incident fractures, with clinical diagnoses made for 16.3% of the radiographic vfx with SQ grade change ≥2. Of incident clinical vfx, 86.5% were identified as incident radiographic vfx, most of them with SQ grade change ≥2. In summary, less than 15% of incident radiographic vfx were also clinically diagnosed, whereas the majority of incident clinical vfx were identified as severe radiographic vfx. These results in men supplement those previously published for women and suggest a complex relationship between clinical and radiographic vfx in older adults. Published 2016.(†) American Society for Bone and Mineral Research.
为了确定老年男性中同时被诊断为新发临床椎体骨折（vfx）的新发影像学椎体骨折的比例，反之亦然，我们使用了参加男性骨质疏松性骨折（MrOS）研究的4398名年龄≥65岁的社区居住男性的数据。通过使用半定量（SQ）方法比较基线和随访时的胸部和腰椎侧位研究片（两次拍片之间平均间隔4.6年）来确定新发影像学vfx，并将其定义为从基线到随访研究X光片，给定椎体水平的SQ读数变化≥1。每三年联系参与者以确定新发临床vfx；获取社区脊柱影像学研究资料，当研究放射科医生确定社区影像学研究显示的新畸形程度高于基线研究X光片中同一椎体时，新发临床vfx得到确认。在197名男性中总共确定了237例新发影像学vfx，而31名男性经历了37例确诊的新发临床vfx。在新发影像学vfx中，13.5%也被临床诊断为新发骨折，对于SQ分级变化≥2的影像学vfx，临床诊断率为16.3%。在新发临床vfx中，86.5%被确定为新发影像学vfx，其中大多数SQ分级变化≥2。总之，不到15%的新发影像学vfx也被临床诊断，而大多数新发临床vfx被确定为严重的影像学vfx。这些男性的结果补充了之前发表的女性结果，并表明老年人临床和影像学vfx之间存在复杂的关系。2016年发表。（†）美国骨与矿物质研究学会。
