The Radiology of Osteoporotic Vertebral Fractures Redux

Identifying osteoporotic vertebral endplate and cortex fractures

“…The radiographic signs of osteoporotic VF include: (I) loss of self-similarity between adjacent vertebrae; (II) loss of parallelism between adjacent end-plates; (III) end-plate disruption as they are impacted into the vertebral body; (IV) fractures of vertebral cortex or end-plate characterized by cortical discontinuities; (V) buckling of the vertebral cortex, especially anteriorly (13). A number of morphometrical and radiological methods for detecting osteoporotic VF have been proposed, but there is no consensus regarding the definition of VFs (5,(13)(14)(15)(16).…”

“…A number of morphometrical and radiological methods for detecting osteoporotic VF have been proposed, but there is no consensus regarding the definition of VFs (5,(13)(14)(15)(16). We feel a combined approach based on standardized radiologic evaluation by experts aided by quantitative measurement to ensure the consistence is the most appropriate approach to detect and classify VF.…”

“…Emphasis is particularly dedicated to identifying vertebral ECF which may not be associated apparent vertebral body collapse. This article tries to avoid overlap or repeat many excellent reviews recently published on the topic of the osteoporotic spine fracture, such as references (5,13,(25)(26)(27)(28)(29). It is in the accurate diagnosis of asymptomatic VFs that radiologists can make the most significant contribution to osteoporotic patient care.…”

Misdiagnosis of vertebral fractures on plain films: Are radiologists really working so bad?

“…We think these discrepancies may have potentially introduced a bias. Although most moderate and all severe VFs are easily recognized, no clear agreement exists about the criteria to use for diagnosing lower grade VFs [4]. Even though GSM remains the most widely used classification, recent reviews stated no evidence to support the use of a specific diagnostic method compared to others [4].…”

“…Although most moderate and all severe VFs are easily recognized, no clear agreement exists about the criteria to use for diagnosing lower grade VFs [4]. Even though GSM remains the most widely used classification, recent reviews stated no evidence to support the use of a specific diagnostic method compared to others [4]. Notably, some limitations are also reported for ABQ method, which was used by Diacinti et al to improve their analysis [4].…”