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Joint Bone Spine
Volume 77, n° S2
pages 113-116 (décembre 2010)
Doi : 10.1016/S1297-319X(10)70005-1
Severe osteoporosis: does structural monitoring help?

Ariane Leboime a, Claire David b, Nadia Mehsen c, Julien Paccou d, Cyrille B. Confavreux e, Christian Roux a,
a Université Paris-Descartes, Hôpital Cochin, Service de Rhumatologie B, 27, rue du faubourg Saint-Jacques, Paris, France 
b Service de Rhumatologie, CHU Hôpital Sud, 16, boulevard de Bulgarie, Rennes, France 
c CHU Pellegrin, Service de Rhumatologie, 1, place Amélie Raba Léon, Bordeaux, France 
d Département Universitaire de Rhumatologie, CHU, Hôpital Roger Salengro, Lille, France 
e INSERM U831 et Université de Lyon, Service de Rhumatologie, Hospices Civils de Lyon, Lyon, France 

Corresponding author.

Vertebral fractures, the most common osteoporotic fractures, are associated with excess mortality even in the absence of symptoms. Presence of at least one radiological or clinical prevalent vertebral fracture increases the risk of incident vertebral fractures not only in untreated patients, but also in treated patients, as established by studies involving routine radiological monitoring. Therefore, whether structural monitoring is indicated on a routine basis deserves discussion. Height measurement is a basic monitoring tool for detecting new vertebral fractures. However, loss of height is nonspecific. Radiography involves radiation exposure levels and financial costs that are not consistent with use for routine monitoring. Vertebral fracture assessment based on dual-energy X-ray absorptiometry (VFA), in contrast, is an inexpensive method that delivers only low radiation levels. VFA used in conjunction with absorptiometry may be well suited to the monitoring of women with severe osteoporosis.

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Keywords : Osteoporosis, Structural monitoring, Radiographs, Vertebral fracture assessment

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