Diagnosis of osteoporotic vertebral fractures

Vertebral fractures are the hallmark of osteoporosis, and are associated with increased morbility and mortality. Because a majority of vertebral fractures often occur in absence of specific trauma and are asymptomatic, their identification is radiographic. The two most widely used methods to determine the severity of vertebral fractures are the visual semiquantitative assessment and the morphometric quantitative approach, involving the measurements of vertebral body heights. Actually the measurements may be made on conventional spinal radiographs (MRX: morphometric X-ray radiography) or on absorptiometric images (MXA: morphometric X-ray absorptiometry). The main advantage of MXA is that the effective dose-equivalent to the patient is considerably lower than for conventional radiography. It also allows combined evaluation of vertebral fracture status and bone mass density, improving selection of candidates for therapeutic intervention.