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14 September 2019 : Clinical Research  

Clinical Utility of a Semiquantitative Method Using Lumbar Radiography as a Screening Tool for Osteoporosis in Elderly Subjects

Keiko Kunitoki12ABCDEF, Tatsushi Mutoh12CDEFG*, Yasuko Tatewaki12ABE, Yumi Takano12BE, Shuzo Yamamoto12BE, Hideo Shimomura13EG, Manabu Nakagawa13BE, Hiroyuki Arai2E, Yasuyuki Taki12DEF

DOI: 10.12659/MSM.917035

Med Sci Monit 2019; 25:6917-6923

Abstract

BACKGROUND: Osteoporosis is a major global public health problem in the current aging era. Osteoporosis is often diagnosed only after patients have a fracture that causes a severe decline in ability to perform activities of daily life. Although the current criterion standard for diagnosing osteoporosis is dual-energy X-ray absorptiometry (DXA), this modality remains less prevalent among general practitioners in geriatric medicine. The aim of this study was to determine the diagnostic utility of visual inspection of lumbar radiography in detecting bone mineral density (BMD) decline.

MATERIAL AND METHODS: We retrospectively reviewed medical data of 78 patients who underwent both lateral lumbar radiography and DXA. Board-certified radiologists determined the clinical grade of each patient’s condition according to the semiquantitative (SQ) method of lumbar fracture assessment. We compared the grades and young adult means of BMD in the lumbar spine and hips as measured using DXA.

RESULTS: BMD of the femoral neck was significantly lower in patients with severe osteoporosis (grades 2 and 3 as classified using the SQ method) than in those with mild osteoporosis (grades 0 and 1; P<0.05). A receiver operating characteristic curve analysis showed that the SQ method can help predict the decrease in BMD (young adult mean score of <70%) in the femoral neck with moderate accuracy (sensitivity, 0.621; specificity, 0.829; area under the curve, 0.742).

CONCLUSIONS: These results suggest that lateral lumbar radiography can provide useful information about bone mineral status and can serve as a tool for osteoporosis screening by general practitioners.

Keywords: Absorptiometry, Photon, Bone Density, Frail Elderly, Osteoporosis, Radiography, Aged, 80 and over, Femur Neck, Lumbar Vertebrae, ROC Curve, Regression Analysis, young adult

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750