AB1147 VERTEBRAL FRACTURE ASSESSMENT : A SIMPLE TOOL TO DETECT VERTEBRAL FRACTURE IN THE OSTEOPOROSIS ASSESSMENT OF PATIENTS WITH TYPE2 DIABETES MELLITUS

Abstract

Background Vertebral fracture assessment ( VFA) has several benefits, including substantially lower radiation dose, lower cost, higher patient convenience, and less operator-dependent variance,VFA can be directly assessed during bone mineral density ( BMD) measurement Objectives: evaluate the accuracy of VFA performed in the supine position by using conventional visual radiography of the spine as the reference standard in patients with type 2 diabetes mellitus Methods A total of 207 patients with type 2 diabetes mellitus (mean age, 46,59 ±7,53years; range, 21–60 years) consisting of 102 women and 105 men,who were suspected of having osteoporosis and who underwent VFA in the supine position and radiography of the spine were evaluated. VFA was analyzed by using a six-marker point method to describe the shape and deformity of each vertebra. Visual radiography of the lateral spine was performed by an experienced radiologist. The agreement between VFA and visual radiography, was assessed by using weighted ƙ statistics. Results Visual radiography helped identify 51 (24.6%) patients with at least one vertebral fracture versus 49(23,67%) with VFA. Most fractures were present in T7, T12, and L1. Excellent agreement was found between VFA and visual radiography, with 97. 3% concordance and ƙ 0.89. Sensitivity, specificity, and positive and negative predictive values calculated by lesion level for VFA compared with visual assessment were 90.2%, 98.08%, 93.88%, and 96.84%, respectively. Conclusion VFA performed with patients with type 2 diabetes, in the supine position, is an accurate method to help detect vertebral fractures when compared with conventional spine radiography. VFA permits combination of fracture assessment with bone mineral density measurement in a single session References [1] -Jacobs-Kosmin D, Sandorfi N, Murray H, Abruzzo JL. Vertebral deformities identified by vertebral fracture assessment: associations with clinical characteristics and bone mineral density. J Clin Densitom 2005;8: 267–272. [2] -Binkley N, Krueger D, Gangnon R, Genant HK, Drezner MK. Lateral vertebral assessment: a valuable technique to detect clinically significant vertebral fractures. Osteoporos Int 2005;16:1513–1518. [3] -Schousboe JT, DeBold CR. Reliability and accuracy of vertebral fracture assessment with densitometry compared to radiography in clinical practice. Osteoporos Int 2006;17: 281–289 Disclosure of Interests None declared