Clinical relevance of vertebral fractures.

Existing vertebral fractures are often missed because they are clinically difficult to diagnose, because recognition of the fractures on radiological images is difficult or because the clinical relevance of the diagnosis of vertebral fractures may be underestimated by the treating physician. There is every reason to focus on the diagnosis and treatment of vertebral fractures: they are strong predictors of new vertebral and nonvertebral fractures, they are associated with significant morbidity, and, particularly importantly, effective anti-osteoporotic drugs are available. In the diagnostic work-up, vertebral morphometry in combination with dual energy X-ray absorptiometry (DEXA) can be valuable. The disadvantage of the poorer image quality, particularly in the higher thoracic region, is amply compensated for by the efficiency and diagnostic convenience to the patients and reduced exposure to radiation.