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Practical use of bone scan in patients with an osteoporotic vertebral compression fracture.

Jun DS, An BK, Yu CH, Hwang KH, Paik JW - J. Korean Med. Sci. (2015)

Bottom Line: The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography.However, no statistical significances were found.In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Incheon, Korea.

ABSTRACT
Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.

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Simultaneous rib fractures in patients with OVCF.
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Figure 1: Simultaneous rib fractures in patients with OVCF.

Mentions: A single nuclear medicine specialist was in charge of reading bone scan images. Rib fracture occurrence was recorded regardless of how many hot uptakes were present in ribs (Fig. 1). In order to explore factors potentially affecting the presence of rib fracture, the factors analyzed were age, sex, number and locations of fractured vertebrae, the bone mineral density (T-score), and compression rates as determined using initial radiography. Regarding the influence of age, patients were divided into two groups of greater than 80 yr and less than 80 yr, and then into four groups of patients aged under 60 yr, 60-69 yr, 70 to 79 yr, and over 80 yr. In order to determine whether number of fractured vertebrae affected the occurrence of rib fracture, patients were divided into groups based on the presence of a single OVCF or multiple OVCF. Also, analyses were done for thoracic fractures, lumbar fractures, and combined fractures in thoracic & lumbar spines to determine the influence of OVCF site on the presence of rib fractures. To confirm the influence of the bone mineral density, patients with BMD (L1-L4, T-scores) of greater than -2.5 and less than -2.5 were compared. Regarding the initial amount of anterior height loss, patients were divided into two groups of anterior height loss greater than and less than 15%. Pearson's chi-square test was conducted to investigate the correlation between the prevalence of rib fracture and each of the above-mentioned factors. Statistical analysis was performed using SPSS ver. 21.0.


Practical use of bone scan in patients with an osteoporotic vertebral compression fracture.

Jun DS, An BK, Yu CH, Hwang KH, Paik JW - J. Korean Med. Sci. (2015)

Simultaneous rib fractures in patients with OVCF.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310947&req=5

Figure 1: Simultaneous rib fractures in patients with OVCF.
Mentions: A single nuclear medicine specialist was in charge of reading bone scan images. Rib fracture occurrence was recorded regardless of how many hot uptakes were present in ribs (Fig. 1). In order to explore factors potentially affecting the presence of rib fracture, the factors analyzed were age, sex, number and locations of fractured vertebrae, the bone mineral density (T-score), and compression rates as determined using initial radiography. Regarding the influence of age, patients were divided into two groups of greater than 80 yr and less than 80 yr, and then into four groups of patients aged under 60 yr, 60-69 yr, 70 to 79 yr, and over 80 yr. In order to determine whether number of fractured vertebrae affected the occurrence of rib fracture, patients were divided into groups based on the presence of a single OVCF or multiple OVCF. Also, analyses were done for thoracic fractures, lumbar fractures, and combined fractures in thoracic & lumbar spines to determine the influence of OVCF site on the presence of rib fractures. To confirm the influence of the bone mineral density, patients with BMD (L1-L4, T-scores) of greater than -2.5 and less than -2.5 were compared. Regarding the initial amount of anterior height loss, patients were divided into two groups of anterior height loss greater than and less than 15%. Pearson's chi-square test was conducted to investigate the correlation between the prevalence of rib fracture and each of the above-mentioned factors. Statistical analysis was performed using SPSS ver. 21.0.

Bottom Line: The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography.However, no statistical significances were found.In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Incheon, Korea.

ABSTRACT
Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.

Show MeSH
Related in: MedlinePlus