Reporting of Osteoporotic Vertebral Fracture Detected Opportunistically on Thoraco-abdominal Computed Tomography

Full Article

L Catalan, F Xiao, JF Griffith

Hong Kong J Radiol 2019;22:230-4

Introduction: The aim of the present study was to investigate the reporting of opportunistic vertebral fracture detected on sagittal spinal reconstructions during thoraco-abdominal computed tomography (CT) examinations.
Methods: CT examinations and radiological reports of 500 patients aged >50 years, with no known malignancy or recent trauma history, who underwent thoraco-abdominal CT examinations from March to June 2017 at our hospital were reviewed. The study group included 290 men and 210 women, mean age 65 ± 9 years. A standardised semi-quantitative approach was used to identify and grade vertebral fracture. All cases were reviewed by a single experienced musculoskeletal radiologist. Patients with clear metastatic fracture (n = 31) were excluded. CT reports of all patients with osteoporotic vertebral fracture were reviewed.
Results: Of 469 patients, 69 (15%) had one or more fractures. Of these fractures, only 29 (42%) were reported in the CT reports. The terminology used for fracture description was ambiguous in 25 (86%) of the 29 reports including terms such as ‘collapse’ (n = 20, 80%), ‘wedging’ (n = 4, 16%), and ‘loss of height’ (n = 1, 4%). In no case was the severity of the fracture accurately recorded in the radiological report.
Conclusion: Opportunistic osteoporotic vertebral fractures were mostly unreported. For fractures that were reported, descriptions were ambiguous and severities were under-reported. Radiologists are encouraged to routinely report clinically relevant osteoporotic vertebral fractures on thoraco-abdominal CT accurately and nonambiguously.


Author affiliation(s):
L Catalan: Augustana College, Rock Island, Illinois, United States
F Xiao, JF Griffith: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong





L Catalan、F Xiao、JF Griffith


方法:回顧2017年3月至2017年6月在本院接受胸腹CT檢查的500例50歲以上,無惡性腫瘤或近期外傷史患者的CT檢查及影像學報告。研究組包括290名男性和210名女性,平均年齡65±9歲。使用標準半定量方法來識別和分級椎體骨折。由轉移性腫瘤引發的椎體骨折患者(n = 31)被排除在外。本文回顧了所有CT報告中提到有骨質疏鬆性椎體骨折的病人圖像。
結果:在469例患者中,有69例(15%)有一個或多個骨折。在這些骨折報告中,CT報告佔29例(42%),當中25個(86%)用於描述骨折的術語不明確,包括「塌陷」(n = 20,80%)、「楔形」(n = 4,16%)和「高度下降」(n = 1,4%)。放射學報告中均沒有準確記錄骨折的嚴重程度。