The omissions increase the risk of future fractures, including potentially devastating and life-threatening hip fractures, according to the authors of the retrospective study published online on 7 August in Archives of Osteoporosis.
The researchers reviewed a cohort of 732 patients older than 50 with a hip fracture. Of those subjects, 157 (21%) patients underwent imaging of the spine with x-ray, CT, or MRI one or more times during the five years prior to their fracture. Vertebral fragility fractures (VFFs) were seen in 65 (41%) cases, but only 30 (46%) of those fractures were reported by the radiologist when first seen.
Nonmusculoskeletal radiologists further exacerbated the issue and were responsible for 91% of the unreported vertebral fragility fractures, which are often related to osteoporosis. In a related finding, only 25% of the patients identified with a vertebral fragility fracture were reported as being on osteoporosis therapy at the time of hip fracture.
"It is essential that radiologists are vigilant for the presence of VFFs on routine imaging, particularly in older patients," said lead author Dr. Ruth M. Mitchell, from Merton College at the University of Oxford. "Equally important is having an effective referral system in place to ensure these patients, once identified, are directed to fracture prevention services."
The combined aforementioned approach to patient care will increase the number of patients receiving "effective osteoporosis therapy," she added, "protecting against future hip fractures and the associated mortality, morbidity, and cost."
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