Evidence map›Paper›PMID 28488133›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

Are bilateral decubitus views necessary in assessing for vertebral compression fractures using DXA vertebral fracture assessment?

Y-C Lin, T-S Huang, J S Wu, Y-C Cheung, Y-H Huang, C-M Sung, Y-H Juan, F-P Chen, J M Ni Mhuircheartaigh

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Y-C LinMedical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan.
T-S HuangKeelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan.
J S WuDepartment of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA, 02215, USA.
Y-C CheungDepartment of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou/Taoyuan and Chang Gung University, 5 Fu-Shin Street, Kuei-Shan, Taoyuan, 333, Taiwan.
Y-H HuangMedical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan.
C-M SungMedical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan.
Y-H JuanDepartment of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou/Taoyuan and Chang Gung University, 5 Fu-Shin Street, Kuei-Shan, Taoyuan, 333, Taiwan.
F-P ChenKeelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan. yuching1221@hotmail.com.
J M Ni MhuircheartaighDepartment of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA, 02215, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The purpose of this study is to assess the differences in VFA diagnostic accuracy when using bilateral decubitus views and whether diagnostic accuracy is affected by scoliosis. Our findings show that the current practice of performing only one side is valid; however, bilateral views can improve specificity in scoliosis.

introductionThe diagnostic accuracy of vertebral fracture assessment (VFA) can be influenced by poor patient position and scoliosis. This study aims to assess the differences in VFA diagnostic accuracy for right and left lateral decubitus views and the effect of scoliosis.

methodsOne hundred fourteen postmenopausal women received right and left lateral thoracolumbar spine dual-energy VFA and radiography. Cobb angles were measured from the posteroanterior absorptiometry image, and lumbar spine radiography was the standard reference for vertebral fracture and also provides the levels investigated. McNemar's test was used to compare accuracy between the two decubitus position and Fisher's exact test was used for patients with and without scoliosis.

resultsForty-two vertebral fractures (VFs) were identified. There was no significant difference in sensitivity (p = 0.125) or specificity (p = 0.866) between the left lateral decubitus (64.3, 97.2%) and right lateral decubitus (76.2, 91.1%), respectively, views. Scoliotic patients had a significantly worse specificity (92.7 vs 98.1%, p = 0.003) than patients without scoliosis; however, a combination of both decubitus positions significantly improved specificity (p < 0.001).

conclusionRight and left side lateral decubitus views have excellent agreement with radiography and similar diagnostic accuracy in the detection of VFs. Thus, the current practice of performing only one side is valid. With scoliosis, bilateral decubitus views can improve the specificity of detecting VF; however, this would increase radiation dose.

Indexed as

Absorptiometry, PhotonAgedAged, 80 and overFemaleFractures, CompressionHumansLumbar VertebraeMiddle AgedOsteoporosis, PostmenopausalOsteoporotic FracturesRadiographyScoliosisSensitivity and SpecificitySpinal FracturesDual-energy X-ray absorptiometryDXA vertebral fracture assessmentMorphometric X-ray absorptiometryOsteoporosisScoliosisVertebral fractures

Identifiers

PMID28488133

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.