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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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Frequency of simultaneous rib fracture.
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Figure 4: Frequency of simultaneous rib fracture.

Mentions: A total of 122 patients (43%) showed hot uptakes in ribs (Fig. 4). When patients were divided into two groups by age, 18 of 49 (36.7%) patients aged over 80 yr and 104 of 235 (44.3%) patients aged under 80 yr had hot uptakes in ribs. When patients were classified into the four groups by age like above, hot uptake in ribs was observed in 9 of 24 (37.5%) in the under 60 yr, in 31 of 82 (37.8%) in the 60-69 yr, in 64 of 129 (49.6%) in the 70-79 yr, and in 18 of 49 (36.7%) in the over 80 yr. In the analysis by sex, 29 of 63 (46.3%) male patients and 93 of 221 (42.1%) females showed hot uptakes in ribs. 85 of 204 (41.7%) in the single vertebral fracture group and 37 of 80 (46.3%) in the multiple vertebral fracture group showed hot uptakes in ribs. When patients were divided into thoracic, lumbar, and both thoracic and lumbar groups by the site of fracture, 51 of 114 (44.7%), 54 of 133 (40.6%), and 17 of 37 (46.0%) had rib fractures. Regarding the bone mineral density, 44.4% (72/162) of those with T-scores (≤-2.5) and 42.6% (52/122) of those with T-scores (>-2.5) showed hot uptakes in the ribs. For initial amounts of anterior height loss, 30 of 60 (50.0%) of those with an anterior height loss of under 15%, and 107 of 224 (47.7%) of those with an anterior height loss of over 15% had rib fractures.


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)

Frequency of simultaneous rib fracture.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Frequency of simultaneous rib fracture.
Mentions: A total of 122 patients (43%) showed hot uptakes in ribs (Fig. 4). When patients were divided into two groups by age, 18 of 49 (36.7%) patients aged over 80 yr and 104 of 235 (44.3%) patients aged under 80 yr had hot uptakes in ribs. When patients were classified into the four groups by age like above, hot uptake in ribs was observed in 9 of 24 (37.5%) in the under 60 yr, in 31 of 82 (37.8%) in the 60-69 yr, in 64 of 129 (49.6%) in the 70-79 yr, and in 18 of 49 (36.7%) in the over 80 yr. In the analysis by sex, 29 of 63 (46.3%) male patients and 93 of 221 (42.1%) females showed hot uptakes in ribs. 85 of 204 (41.7%) in the single vertebral fracture group and 37 of 80 (46.3%) in the multiple vertebral fracture group showed hot uptakes in ribs. When patients were divided into thoracic, lumbar, and both thoracic and lumbar groups by the site of fracture, 51 of 114 (44.7%), 54 of 133 (40.6%), and 17 of 37 (46.0%) had rib fractures. Regarding the bone mineral density, 44.4% (72/162) of those with T-scores (≤-2.5) and 42.6% (52/122) of those with T-scores (>-2.5) showed hot uptakes in the ribs. For initial amounts of anterior height loss, 30 of 60 (50.0%) of those with an anterior height loss of under 15%, and 107 of 224 (47.7%) of those with an anterior height loss of over 15% had rib fractures.

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