J Korean Med Sci.  2015 Feb;30(2):194-198. 10.3346/jkms.2015.30.2.194.

Practical Use of Bone Scan in Patients with an Osteoporotic Vertebral Compression Fracture

• Jun DS
• An BK
• Yu CH
• Hwang KH
• Paik JW

• KMID: 2129651
• DOI: http://doi.org/10.3346/jkms.2015.30.2.194

Abstract

Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.

Keyword

Osteoporosis; Spine; Compression Fracture; Rib Fracture; Osteoporotic Fracture

MeSH Terms

Aged
Aged, 80 and over
Bone Density
Female
Fractures, Compression/diagnosis/*epidemiology/radiography
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Osteoporosis/pathology/*radiography
Osteoporotic Fractures/diagnosis/*epidemiology/radiography
Rib Fractures/*epidemiology
Spine/pathology
Tomography, X-Ray Computed

Figure

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  Fig. 1 Simultaneous rib fractures in patients with OVCF.

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  Fig. 2 Two-site fractures. (A) Thoracic and lumbar vertebral fractures (hot uptake) in a bone scan. Thoracic (B) and lumbar (C) MRI depicting only one vertebral fracture in the same patient.

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  Fig. 3 Mild compression fracture by plane radiography. When the amount of anterior height loss associated with a fractured vertebra is less than 15%, the fracture may be overlooked on plane radiographs (A). Vertebral fracture was confirmed by a bone scan (B) and by MRI (C, white arrow).

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  Fig. 4 Frequency of simultaneous rib fracture.

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