Skip to main content
The Ulster Medical Journal logoLink to The Ulster Medical Journal
. 2003 May;72(1):34–37.

How reliable is a radiological report in osteoporosis in diagnosing low bone density?

C D McCullagh 1, K McCoy 1, V L S Crawford 1, H Taggart 1
PMCID: PMC2475391  PMID: 12868701

Abstract

Patients are often referred to osteoporosis clinics with a radiological diagnosis of osteoporosis. Previous studies attempting to ascertain risk of osteoporosis from radiographs have been conflicting. The aim of our study was to determine how reliable spinal radiographs were at detecting low bone density compared with Dual Energy X ray Absorptiometry (DXA). We retrospectively measured the Bone Mineral Density (BMD) at the spine in 130 patients with a radiological diagnosis of osteopenia or osteoporosis in the absence of vertebral fractures. They were compared with a group of 119 age and sex matched patients with one or more low trauma vertebral fractures. There was a statistically significant difference in the mean BMD between these two groups. 12.7%, of the x-ray group with osteopenia reported, had a normal bone density, 49.2% had osteopenia (T-score -1 to -2.5) and 38.1% had osteoporosis (T-score <-2.5). Of those with a radiological report of osteoporosis, 12.8% had a normal bone density, 44.7% had osteopenia and 42.6% had osteoporosis. We conclude that a radiological report of low bone density is a strong predictor of osteopenia or osteoporosis by BMD measurement.

Full text

PDF
34

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahmed A. I., Ilic D., Blake G. M., Rymer J. M., Fogelman I. Review of 3,530 referrals for bone density measurements of spine and femur: evidence that radiographic osteopenia predicts low bone mass. Radiology. 1998 Jun;207(3):619–624. doi: 10.1148/radiology.207.3.9609882. [DOI] [PubMed] [Google Scholar]
  2. Epstein D. M., Dalinka M. K., Kaplan F. S., Aronchick J. M., Marinelli D. L., Kundel H. L. Observer variation in the detection of osteopenia. Skeletal Radiol. 1986;15(5):347–349. doi: 10.1007/BF00348859. [DOI] [PubMed] [Google Scholar]
  3. Espeland A., Korsbrekke K., Albrektsen G., Larsen J. L. Observer variation in plain radiography of the lumbosacral spine. Br J Radiol. 1998 Apr;71(844):366–375. doi: 10.1259/bjr.71.844.9659128. [DOI] [PubMed] [Google Scholar]
  4. Finsen V., Anda S. Accuracy of visually estimated bone mineralization in routine radiographs of the lower extremity. Skeletal Radiol. 1988;17(4):270–275. doi: 10.1007/BF00401810. [DOI] [PubMed] [Google Scholar]
  5. Garton M. J., Robertson E. M., Gilbert F. J., Gomersall L., Reid D. M. Can radiologists detect osteopenia on plain radiographs? Clin Radiol. 1994 Feb;49(2):118–122. doi: 10.1016/s0009-9260(05)83453-1. [DOI] [PubMed] [Google Scholar]
  6. Jergas M., Uffmann M., Escher H., Glüer C. C., Young K. C., Grampp S., Köster O., Genant H. K. Interobserver variation in the detection of osteopenia by radiography and comparison with dual X-ray absorptiometry of the lumbar spine. Skeletal Radiol. 1994 Apr;23(3):195–199. doi: 10.1007/BF00197459. [DOI] [PubMed] [Google Scholar]
  7. Johnston C. C., Jr, Epstein S. Clinical, biochemical, radiographic, epidemiologic, and economic features of osteoporosis. Orthop Clin North Am. 1981 Jul;12(3):559–569. [PubMed] [Google Scholar]
  8. Michel B. A., Lane N. E., Jones H. H., Fries J. F., Bloch D. A. Plain radiographs can be useful in estimating lumbar bone density. J Rheumatol. 1990 Apr;17(4):528–531. [PubMed] [Google Scholar]
  9. Scane A. C., Masud T., Johnson F. J., Francis R. M. The reliability of diagnosing osteoporosis from spinal radiographs. Age Ageing. 1994 Jul;23(4):283–286. doi: 10.1093/ageing/23.4.283. [DOI] [PubMed] [Google Scholar]
  10. Williamson M. R., Boyd C. M., Williamson S. L. Osteoporosis: diagnosis by plain chest film versus dual photon bone densitometry. Skeletal Radiol. 1990;19(1):27–30. doi: 10.1007/BF00197924. [DOI] [PubMed] [Google Scholar]

Articles from The Ulster Medical Journal are provided here courtesy of Ulster Medical Society

RESOURCES