COMPARISON OF THE RADIOGRAPHIC VERTEBRAL TRABECULAR PATTERN WITH THE VERTEBRAL FRACTURE PREVALENCE AND SPINAL BONE-DENSITY

Spinal bone densitometry allows accurate and precise measurement of th e severity of bone loss. Where densitometry is not yet available medic al practitioners have to continue to rely on clinical radiography. Sin ce the grey levels of the radiographic image are highly inaccurate we studied the radiographic vertebral trabecular pattern for its suitabil ity as a semiquantitative assessment of vertebral bone loss. We define d four vertebral trabecular pattern indices (VTPI 4 = normal, VTPI 1 = severe bone loss) and tested these for correlations with the prevalen ce of vertebral fractures, and with spinal and hip bone mineral densit y measured by dual-energy X-ray absorptiometry (DXA). We found negativ e correlations between VTPI and the percentage of patients with verteb ral fractures (p = 0.0001), between VTPI and the number of vertebral f ractures per patient (r = 0.606, p = 0.001) and between VTPI and the s everity of vertebral fractures, and a positive correlation between VTP I and spinal (r(2) = 0.556, p = 0.0001) and hip DXA values (r(2) = 0.3 15, p = 0.0001). We conclude that the vertebral trabecular pattern ind ex can be used to assess the severity of spinal bone loss when a bone densitometer is not available.