Julia Dinges MD, Presenter: Nothing to Disclose

Dirk Mueller MD, Abstract Co-Author: Nothing to Disclose

Jan Stefan Bauer MD, Abstract Co-Author: Nothing to Disclose

Thomas M. Link MD, Abstract Co-Author: Research grant, Merck & Co, Inc

Ernst Josef Rummeny MD, Abstract Co-Author: Nothing to Disclose

Vertebral fractures are a common finding in osteoporosis and have important health consequences. Routine lateral chest radiographs are a potential screening method, but a significant under-reporting has been described by previous studies. Therefore the International Osteoporosis Foundation (IOF) started a teaching initiative to raise the awareness of radiologists to the relevance of accurate reporting of vertebral fractures. The purpose of this study was to evaluate the effect of this specific training on the detection rate of vertebral fractures.

Routine lateral chest radiographs of 800 postmenopausal women (age ≥ 55 years, mean 70.8±9.1) were reviewed in consensus by two experienced radiologists. The spinal fracture index (SFI) was used to assess the thoracic region for vertebral fractures. 400 of those radiographs have been obtained before and 400 after the radiologists of our institution underwent a specific training, based on the IOF teaching initiative. The radiology reports were reviewed, whether osteoporotic spine fractures have been reported by the radiologists.

The prevalence of clinically relevant vertebral fractures (SFI>1) was 21%. Patients with relevant fractures had more than one fracture in 61%. Most fractures were found at T12 (47/800), followed by T8 (42/800). Detection rate was 32% (36/112 fractures) in the untrained group and 83% (101/121) in the trained group. While most fractures were reported at T12 in the trained group (19/19), only 6/20 fractures were reported at T12 in the untrained group. Differences were less pronounced at the level of T8 (trained 20/22, untrained 15/20).

Lateral chest radiographs are a screening method for osteoporotic vertebral fractures. However, specific training is required to optimize the accurate detecting and reporting of osteoporotic vertebral fractures. The teaching initiative of the IOF demonstrated to be well suited to support this training.

A brief training is crucial to increase the awareness of radiologists for the correct report of vertebral insufficiency fractures. The teaching initiative by the IOF may suite as a useful assistance.

Dinges, J, Mueller, D, Bauer, J, Link, T, Rummeny, E, Impact of Training in Detecting Osteoporosis-related Spine Fractures on Routine Lateral Chest Radiographs.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6021384.html