241 ‘Please consider bone assessment’: improving the identification and management of Vertebral Fractures by a ‘Fracture Liaison Service’

Abstract

Abstract Background Osteoporotic fractures are a major public health problem due to an ageing population causing profound disability and reduced quality of life. Vertebral Fractures (VFs) are the second most common osteoporotic fracture with nearly 1 in 4 women having one in their lifetime. Furthermore, a VF is a significant warning sign for another fracture in the following year—known as ‘imminent fracture risk’. Despite this early opportunity for clinical intervention with bone protective medication, VFs are frequently under-diagnosed and under-treated. This observational study aimed to look at the point prevalence of VFs picked up on radiology reports and compare with those identified by the ‘Fracture Liaison Service’ (FLS). Methods The PACs office ran a search for all MRI spine, CT-TAP and a plain radiographic film reports from January 2021 until April 2023 with the terms ‘vertebrae’ and ‘compression’ in the text. Inclusion criteria was all patients >65 without major trauma with a radiologist defined osteoporotic VF. Using excel, we cross-referenced the proportion of these already know to the FLS. Results There were 338 osteoporotic VFs diagnosed on radiological imaging between 2021 & 2023. Of these, 101 had been identified by the FLS. The median age was 77 years old. There were 228 (67.2%) females and 111 (32.8%) males. Conclusion This study helped to highlight that over 67.2% of the osteoporotic VFs are not being identified by the FLS. Therefore, is it assumed that timely intervention and management of their imminent fracture risk may not have been undertaken. This data is being used to drive a quality improvement project with the radiology department where any VF in women >70 will be reported to include—‘please consider bone assessment’.