Vertebral fracture assessment scans enhance targeting of investigations and treatment within a fracture risk assessment pathway

Abstract

Introduction of a fracture risk assessment service incorporating VFA and a one-stop pathway has enhanced vertebral fracture identification and targeting of treatment and management.

Opportunistic Identification of Vertebral Fractures

“…In our unit, we perform VFA in patients referred for BMD in women aged more than 65 yr, men aged more than 70 yr and all who have had significant (O5 mg/d for longer than 3 mo) oral glucocorticoid therapy over 45 yr, and who have not had any spinal imaging in the previous past 12 mo. Such a protocol can enhance vertebral fracture identification and so improve targeted treatment and management (26).…”

Cancer treatment-induced bone loss (CTIBL): Pathogenesis and clinical implications

“…Clinical evidence of vertebral collapse includes height loss of more than 4 cm and acute back pain. A lateral radiogram of the thoracic and lumbar spine is usually enough to detect the presence of asymptomatic fractures [84]. The WHO provides a clinical tool, namely the Fracture Risk Assessment tool (FRAX), to evaluate the 10-year probability of major osteoporotic fractures based on age, sex, clinical risk factors, femoral neck BMD and other information [85].…”

NCCN Task Force Report: Bone Health in Cancer Care

“…Many patients with vertebral fractures may not have T scores classified as osteoporosis. 21 Independent of BMD and other clinical risk factors, existing vertebral fractures are a strong predictor of future fractures. Women with vertebral fractures have a 5-fold increased risk of a new vertebral fracture and a 2-fold increased risk of hip fracture.…”