Observer agreement in pediatric semiquantitative vertebral fracture diagnosis

Siminoski, Kerry; Lentle, Brian C.; Matzinger, Mary Ann; Shenouda, Nazih; Ward, Leanne M.

doi:10.1007/s00247-013-2837-4

Cited by 24 publications

(33 citation statements)

References 37 publications

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“…Our study did not confirm the effect of low BMD, high BMI or short stature on readability, as shown previously [30,34,37], but the non-readable subjects were younger and this may imply a smaller body size. Radiography has also been associated with difficulty in visualising the mid to upper thoracic levels, albeit to a lesser extent than VFA [24,27,[31][32][33][34][35][36]38], such that when spine radiographs of children with newly diagnosed leukaemia were evaluated, the authors reported that only 5% of vertebrae were unreadable but this rose to 17% in the T4-T7 region in the same cohort [39].…”

Section: Discussionmentioning

confidence: 95%

“…In contrast, in our study the VF missed by VFA belonged to all grades of severity. Whilst conventional radiography is considered the gold standard for VF identification, it is important to note that, intraobserver and interobserver variability in fracture identification exists even among expert radiologists evaluating radiographs, recognising that spine radiographs also have limitations in the evaluation of VF [29,39,41,42].…”

Section: Discussionmentioning

confidence: 99%

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A critical appraisal of vertebral fracture assessment in paediatrics

Kyriakou

Shepherd

Mason

et al. 2015

Bone

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

A critical appraisal of vertebral fracture assessment in paediatrics

Kyriakou

Shepherd

Mason

et al. 2015

Bone

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“…The lateral spine X-ray currently is the most commonly used imaging technique to evaluate VFs in children but radiation exposure is high. The Genant semiquantitative method is a technique used to grade VF in adults (21), with good reproducibility in children (22). The newest generation of DXA scanners allows VF assessment (VFA) to be performed on lateral scanning.…”

Section: Assessment Of Bone Mass and Structurementioning

confidence: 99%

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Saraff

Högler

2015

European Journal of Endocrinology

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Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for longterm safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis.

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“…Otra forma de evaluar la morfología de las vértebras es medir la altura en el plano sagital del cuerpo vertebral en su muro anterior y posterior, determinando una proporción entre ambas medidas: la relación A/P esperable es sobre 89% 3 . La limitante de esta medición es que puede haber variabilidad inter e intraobservador, lo que dificulta la pesquisa de anomalías vertebrales 15 . La primera descripción de cifosis asociada a hipoplasia vertebral la realizó L. Swischuk en el año 1970, atribuyendo dicha alteración a hipotonía, exageración de la cifosis normal del área toracolumbar, herniación anterior del núcleo pulposo y subluxación anterior del cuerpo vertebral 16 .…”

Section: Discussionunclassified

Hipoplasia vertebral asociada a cifosis toracolumbar en lactantes ¿variante anatómica? Casos clínicos

Tampe

Espinoza

et al. 2018

Rev. chil. pediatr.

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Palabras clave:Cifosis; deformidades de columna; hipoplasia vertebral; vértebra lumbar ResumenIntroducción: La hipoplasia vertebral es una anomalía de los cuerpos vertebrales, en la que estos tienen forma de cuña, habitualmente a nivel de la unión toracolumbar. Si bien se asocia a ciertas enfermedades de depósito y displasias óseas, es posible encontrar una hipoplasia vertebral aislada en lactantes sanos, o en presencia de cifosis toracolumbar. El objetivo del presente manuscrito es dar a conocer la evolución de la hipoplasia vertebral asociada a cifosis en dos lactantes aparentemente sanos. Casos Clínicos: Se presentan dos casos de lactantes en que se pesquisó cifosis lumbar clíni-camente visible durante la sedestación. Las radiografías de columna de ambos mostraron hipoplasia vertebral lumbar a nivel de L2 como único hallazgo en la morfología vertebral. Luego de descartar causas asociadas, se indicó manejo conservador: en el primer caso, en que la cifosis era de 18º se indicó seguimiento clínico-radiológico; mientras que, en el segundo caso, que tenía una angulación de 57º en sedestación, se indicó tratamiento con corsé. La evolución en ambos fue favorable, con resolución clínica radiológica a la edad de 15 meses en el primer caso y en el segundo caso, a los 3 años y 4 meses se constató regresión clínica de la cifosis con persistencia de una imagen de leve hipoplasia vertebral. Conclusiones: La hipoplasia vertebral aislada o asociada a cifosis puede considerarse una anomalía menor o bien una variante anatómica del desarrollo de la columna del lactante, no obstante, requiere seguimiento hasta su normalización. Keywords:Kyphosis; spine deformities; vertebral hypoplasia; lumbar vertebrae Abstract Introduction: Vertebral hypoplasia is an anomaly of the vertebral bodies, in which they present a wedge shape, usually at the level of the thoracolumbar junction. Although it is associated with certain storage diseases and bone dysplasias, it is also possible to find isolated vertebral hypoplasia it in

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Observer agreement in pediatric semiquantitative vertebral fracture diagnosis

Abstract: Background-The Genant semi-quantitative (GSQ) method has been a standard procedure for diagnosis of vertebral fractures in adults, but has only recently been shown to be of clinical utility in pediatrics. Observer agreement using the GSQ method in this age group has not been described.

Cited by 24 publications

References 37 publications

A critical appraisal of vertebral fracture assessment in paediatrics

A critical appraisal of vertebral fracture assessment in paediatrics

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Hipoplasia vertebral asociada a cifosis toracolumbar en lactantes ¿variante anatómica? Casos clínicos

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