Vertebral Fracture Assessment (VFA) identifies many persons with Clinical Osteoporosis who are missed by DXA testing alone. How many? I reviewed my first 941 patients to have VFA with their DXA (Feb 2010 – Sept 2012). I was amazed.
25% of the total had at least one Genant grade 2 or 3 Vertebral Deformity on VFA but were not identified as Osteoporosis by DXA. This is Clinical Osteoporosis missed by DXA alone in 25% of my total patients.
As an orthopedic surgeon, my main concern has been bone quality. Poor bone quality (“mush for bone”) is a big deal when you are placing screws and other implants. Vertebral compression fracture deformities found on VFA have been a more accurate warning of “mush for bone” than BMD by DXA.
“Mush for bone” also predicts fractures
Today I am presenting the full study to the International Society for Clinical Densitometry (ISCD) Annual Meeting & Position Development Conference. I hope to generate discussion. Clearly we need a larger study of many thousands of individuals to better study this issue.
Jay Ginther, MD