Short introduction – commentary
In a recent manuscript, members of 15 international societies in the musculoskeletal field, including ECTS, advocate to use vertebral fracture assessment (VFA) with dual-energy x-ray absorptiometry (DXA) as an additional measurement to BMD assessment by central DXA. They argue that vertebral fractures are strong predictors of both vertebral and nonvertebral fractures, independent of BMD, but the majority of vertebral fractures are clinically silent and are thus underdiagnosed if not searched for. Detection of previously unrecognized vertebral fractures by DXA may affect the estimation of fracture risk and guide treatment decisions.
Based on a comprehensive narrative review of the literature, the authors critically discuss the advantages of VFA by DXA compared to standard radiography and they compare the different VFA scoring methods. In addition, they describe technical requirements for acquisition of VFA by DXA, analysis of the images and interpretation of VFA. They stress that identification of both the number and severity of vertebral fractures is important, as both are independent predictors of incident fractures. Finally, the authors discuss that vertebral deformities may also be due to other conditions like osteoarthritis, but also physiological variations, and thus require proper assessment.
They conclude that VFA should be performed in all patients in whom a DXA-BMD is indicated, as the identification of vertebral fractures can lead to improvement of patient care.
Read the original article here.