Chest x-rays may provide information to help detect osteoporosis in the elderly

April 25, 2005

CHICAGO - Undetected osteoporosis in the elderly might be discovered if chest radiographs (x-ray images) that are done for other reasons were examined for fractures of the vertebrae, according to an article in the April 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Previous studies estimate that 12 to 25 percent of people aged 50 to 60 years have one or more osteoporosis-related vertebral fracture, the most common fracture associated with osteoporosis, according to background information in the article. While only 30 percent of these fractures come to medical attention the other 70 percent are associated with illness, death, decreased quality of life and increased risk of future fractures. The authors suggest that the many chest radiographs elderly patients undergo for other health reasons might be examined to determine the presence of vertebral fractures.

Sumit R. Majumdar, M.D., M.P.H., of the University of Alberta Hospital, Edmonton, Canada, and colleagues selected a random sample of about 10 percent of patients older than 60 who had been evaluated in the emergency department of a large teaching hospital and had a chest radiograph done for any reason. The medical charts and radiographs were then reviewed in detail to determine whether the patient had a moderate-to-severe vertebral fracture.

Seventy-two (16 percent) of the 459 patients had a moderate-to-severe vertebral fracture on the basis of their radiograph. Forty-three (60 percent) of the fractures were documented in the original radiographic reports. Of the 72 patients with fractures, only 18 (25 percent) had histories of osteoporosis. "Even among the patients admitted to the hospital (198) who also had a vertebral fracture (32), there was no documented addition of osteoporosis medications during hospitalization or at discharge," the authors report.

"The most noteworthy finding in our study is the magnitude of the underdiagnosis and undertreatment of osteoporosis in elderly patients with a vertebral fracture," the authors write. "One in six elderly patients who underwent chest radiography in our emergency department had clinically important vertebral fractures. Nevertheless, only 43 (60 percent) of these fractures were reported, and only 25 percent of patients with fractures received a diagnosis of or treatment for osteoporosis."
-end-
(Arch Intern Med. 2005; 165:905-909. Available post-embargo at www.archinternmed.com.)

Editor's Note: This study was supported by grants from Alberta Heritage Foundation for Medical Research, Edmonton. Dr. Majumdar is a Population Health Investigator of the Alberta Heritage Foundation for Medical Research and a New Investigator of the Canadian Institutes of Health Research, Ottawa, Canada. One of the co-authors, Dr. Rowe holds a Canadian Research Chair in Emergency Airway Diseases from the Canadian Institutes of Health Research.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or email mediarelations@jama-archives.org.

The JAMA Network Journals

Related Osteoporosis Articles from Brightsurf:

New opportunities for detecting osteoporosis
Osteoporosis can be detected through low dose computed tomography (LDCT) imaging tests performed for lung cancer screening or other purposes.

Oxytocin can help prevent osteoporosis
In a laboratory experiment with rats, Brazilian researchers succeeded in reversing natural processes associated with aging that lead to loss of bone density and strength.

New strategy against osteoporosis
An international research team has found a new approach that may be able to reduce bone loss in osteoporosis and maintain bone health.

New review on management of osteoporosis in premenopausal women
An IOF and ECTS Working Group have published an updated review of literature published after 2017 on premenopausal osteoporosis.

Cardiac CT can double as osteoporosis test
Cardiac CT exams performed to assess heart health also provide an effective way to screen for osteoporosis, potentially speeding treatment to the previously undiagnosed, according to a new study.

Osteoporosis treatment may also protect against pneumonia
A recent study published in the Journal of Bone and Mineral Research found that nitrogen-containing bisphosphonates (N-BPs) such as alendronate, which are widely used to treat postmenopausal osteoporosis, are linked with lower risks of pneumonia and of dying from pneumonia.

New pharmaceutical target reverses osteoporosis in mice
Biomedical engineers at Duke University have discovered that an adenosine receptor called A2B can be pharmaceutically activated to reverse bone degradation caused by osteoporosis in mouse models of the disease.

A link between mitochondrial damage and osteoporosis
In healthy people, a tightly controlled process balances out the activity of osteoblasts, which build bone, and osteoclasts, which break it down.

Many stroke patients not screened for osteoporosis, despite known risks
Many stroke survivors have an increased risk of osteoporosis, falls or breaks when compared to healthy people.

Many postmenopausal women do not receive treatment for osteoporosis
The benefits of treating osteoporosis in postmenopausal women outweigh the perceived risks, according to a Clinical Practice Guideline issued today by the Endocrine Society.

Read More: Osteoporosis News and Osteoporosis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.