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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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Related in: MedlinePlus

Two-site fractures. (A) Thoracic and lumbar vertebral fractures (hot uptake) in a bone scan. Thoracic (B) and lumbar (C) MRI depicting only one vertebral fracture in the same patient.
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Figure 2: Two-site fractures. (A) Thoracic and lumbar vertebral fractures (hot uptake) in a bone scan. Thoracic (B) and lumbar (C) MRI depicting only one vertebral fracture in the same patient.

Mentions: The authors then tried to determine the efficacy of a bone scan as a screening test on approaching for OVCF by investigating cases of non-adjacent multiple fractures and minimal height loss fractures. Fractures of non-adjacent sites on the thoracic and lumbar spine were not detected in single site MRI images taken just after trauma, but were detected by a bone scan (Fig. 2). Also, in order to confirm the usefulness of a bone scan for identifying fractures that could be missed by plain radiography, frequencies of compression fracture with less than 15% anterior height loss were investigated among patients with a single OVCF (Fig. 3). Amounts of anterior height loss were assessed by calculating the difference between estimated anterior height of vertebra before fracture occurrence and anterior height determined by initial plain radiography. The mean heights of vertebrae superior and inferior to fractured vertebrae were used to estimate anterior heights of fractured vertebrae before fracture occurrence.


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)

Two-site fractures. (A) Thoracic and lumbar vertebral fractures (hot uptake) in a bone scan. Thoracic (B) and lumbar (C) MRI depicting only one vertebral fracture in the same patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Two-site fractures. (A) Thoracic and lumbar vertebral fractures (hot uptake) in a bone scan. Thoracic (B) and lumbar (C) MRI depicting only one vertebral fracture in the same patient.
Mentions: The authors then tried to determine the efficacy of a bone scan as a screening test on approaching for OVCF by investigating cases of non-adjacent multiple fractures and minimal height loss fractures. Fractures of non-adjacent sites on the thoracic and lumbar spine were not detected in single site MRI images taken just after trauma, but were detected by a bone scan (Fig. 2). Also, in order to confirm the usefulness of a bone scan for identifying fractures that could be missed by plain radiography, frequencies of compression fracture with less than 15% anterior height loss were investigated among patients with a single OVCF (Fig. 3). Amounts of anterior height loss were assessed by calculating the difference between estimated anterior height of vertebra before fracture occurrence and anterior height determined by initial plain radiography. The mean heights of vertebrae superior and inferior to fractured vertebrae were used to estimate anterior heights of fractured vertebrae before fracture occurrence.

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