Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis

Authors

  • Lúcia Costa-Paiva Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas
  • Aarão Mendes Pinto-Neto Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas
  • Silvana Filardi Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas
  • Adil Samara Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas
  • João Francisco Marques Neto Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

Keywords:

Osteoporosis, Vertebral fractures, Bone mineral density, Osteophytes, Aortic calcification

Abstract

CONTEXT: Measurements of bone density taken by dual-energy x-ray absorptiometry are the most accurate procedure for the diagnosis of osteoporosis.Thisprocedurehasthedisadvantage ofmeasuringthedensityofallmineralcomponents, includingosteophytes,vascularandextravertebral calcifications. These alterations can influence bone density results and densitometryinterpretation. OBJECTIVE: To correlate radiography and densitometry findingsfromwomenwithosteoporosis,analyzing the influence of degenerative processes and vertebralfracturesontheevaluationofbonedensity. DESIGN: Retrospective study. SETTING: Osteoporosis outpatients’ clinic at Hospital das Clínicas, Universidade Estadual de Campinas. PARTICIPANTS: Ninety-six postmenopausal women presenting osteoporosis diagnosed by bone density. MAIN MEASUREMENTS: Bone mineral density of the lumbarspineandfemoralneckweremeasuredby thetechniqueofdual-energyx-rayabsorptiometry, using a LUNAR-DPX densitometer. Fractures, osteophytesandaorticcalcificationswereevaluated by simple x-rays of the thoracic and lumbar spine. RESULTS: The x-rays confirmed vertebral fractures in 41.6%, osteophytes in 33.3% and calcifications of the aorta in 30.2%. The prevalence of fractures and aortic calcifications increased with age. The mean bone mineral density was 0.783g/cm2 and the mean T-score was –3.47 DP. Neither fractures nor aortic calcifications had significant influence on bone mineral density (P = 0.36 and P = 0.09, respectively),despitethefracturedvertebraehaving greater bone mineral density (P < 0.02). Patients withlumbarspineosteophytesshowedgreaterbone mineral density (P = 0.04). Osteophytosis was associatedwithlumbarspinebonemineraldensity afteradjustmentforfracturesandaorticcalcifications by multiple regression (P = 0.01). CONCLUSION: Osteophytes and lumbar spine fractures can overestimate bone density interpretation. The interpretation of densitometry results should be carried out together with the interpretation of a simple lumbar spine x-ray in elderlywomen.

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Author Biographies

Lúcia Costa-Paiva, Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

MD, PhD. Assistant Professor, Department of Childbirth and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.

Aarão Mendes Pinto-Neto, Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

MD, PhD. Associate Professor, Department of Childbirth and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.

Silvana Filardi, Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

MD. Postgraduate student in Clinical Medicine, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.

Adil Samara, Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

MD, PhD. Full Professor, Discipline of Rheumatology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.

João Francisco Marques Neto, Hospital das Clínicas, Faculty of Medicine Sciences, Universidade Estadual de Campinas

MD, PhD. Full Professor, Discipline de Rheumatology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.

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Published

2002-01-01

How to Cite

1.
Costa-Paiva L, Pinto-Neto AM, Filardi S, Samara A, Marques Neto JF. Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis. Sao Paulo Med J [Internet]. 2002 Jan. 1 [cited 2025 Mar. 18];120(1):9-12. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2665

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