Study finds vertebral fractures are underreported

03/08/04

A team of doctors and researchers at the University of Alberta has discovered that vertebral fractures often go undiagnosed or unreported when elderly patients get chest x-rays to check for other health problems. The researchers hope the results of their study will lead physicians to check more carefully for osteoporosis related vertebral fractures in the future. The research results have been published in the American Journal of Roentgenology.

"Osteoporosis is so much a part of aging that the signs of it, such as vertebral fractures, are often ignored, and this study proves that," said Dr. Sumit Majumdar, a professor of general internal medicine at the U of A and lead author of the study. "We want to educate patients and primary care physicians to be aware of this and work to improve the situation."

The study entailed doctors revisiting 100 random chest x-rays of patients 60 or older, who received the x–rays for symptoms related to the chest and not for back pain. The doctors found that 22 of these patients had vertebral fractures, and that 10 of these 22 cases--45 per cent--were not mentioned in the official radiology reports.

Vertebral fractures are commonly asymptomatic; that is, a person who has such a fracture doesn't feel pain from it and doesn't realize they have a problem, said Dr. Nancy Kim, a radiology resident in the U of A Department of Radiology and Diagnostic Imaging and another author of the study.

The study is significant, Kim added, because vertebral fractures are often indicators of osteoporosis, a common disease among the elderly that weakens bones but is easily treated with drugs.

"Elderly patients get chest x-rays for thousands of reasons, everything from pneumonia to any number of heart conditions," added Dr. Brian Rowe, a professor of emergency medicine and another author of the study. "If doctors could take a moment to also check these x-rays for vertebral fractures it might really help the patient down the road."

"Our health care system is really good at diagnosing and treating acute problems, but it's not so great at providing preventative care," Kim said. "There is a focus on dealing with the acute problems that lead patients to seek help and less emphasis on treating chronic health problems, such as osteoporosis."

"A patient often won't know they have osteoporosis until they fall and break a hip," she added. "This study is a first step to show doctors that they can help us to treat osteoporosis better by taking a closer look at routine chest x-rays."

"Patients should know this and make sure their doctors take that extra step," Majumdar added.

Source: Eurekalert & others

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