Chest Radiography As a Screening Tool to Detect Fragile Spine Fractures

Yasuhiro Suyama¹, Mitsumasa Kishimoto², Taiki Nozaki³, Tetsuhiko Okabe⁴ and Masato Okada², ¹Rheumatology, JR Tokyo General Hospital, Tokyo, Japan, ²Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan, ³Radiology, St. Luke’s International Hospital, Tokyo, Japan, ⁴Radiology, Yokohama City University, Yokohama, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Osteoporosis and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 6, 2017

Title: Osteoporosis and Metabolic Bone Disease – Clinical Aspects and Pathogenesis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Osteoporosis screening is essential in the management of rheumatoid arthritis, and evaluation of fragile spine fractures is one of the recommended examinations. Digital chest radiography is widely available, and the spine can be evaluated by focusing on its lateral view. Therefore, we assessed the usefulness of lateral-view chest radiography in the screening of fragile spine fractures.

Methods: We retrospectively evaluated patients who newly met the 2010 American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis criteria and underwent osteoporosis screening, including chest radiography, spine radiography, FRAX, and dual-energy X-ray absorptiometry within a 1-month interval, from April 2016 to March 2017. The incidental identification of vertebral fracture was evaluated using a semiquantitative approach by two board-certified musculoskeletal radiologist. Radiography was used as the gold standard by both readers to detect vertebral fractures in the thoracic and lumbar spines. We calculated the sensitivity and specificity of chest radiography and compared these with those of the gold standard performed by each radiologist. In addition, kappa statistics between the radiologists were calculated reproductively.

Results: We identified 35 eligible patients (Table 1). Both readers agreed that at least one moderate or severe thoracic fracture was present in 6 patients (17.1%) on spine radiography. The kappa statistics between the radiologists who detected fragile spine fractures using lateral-view chest radiography was 0.982 (95% confidence interval: 0.685–1.000). For thoracic vertebral fractures, the sensitivity and specificity of lateral-view chest radiography in detecting fractures were respectively 100% and 97.1% for radiologist 1 and 100% and 97% for radiologist 2. For lumbar vertebral fractures, the sensitivity and specificity were both 100% for radiologists 1 and 2.

Conclusion: Chest radiography is useful for the screening of fragile spine fractures.

Disclosure: Y. Suyama, None; M. Kishimoto, None; T. Nozaki, None; T. Okabe, None; M. Okada, AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, 2,AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, 5,AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, 9.

To cite this abstract in AMA style:

Suyama Y, Kishimoto M, Nozaki T, Okabe T, Okada M. Chest Radiography As a Screening Tool to Detect Fragile Spine Fractures [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/chest-radiography-as-a-screening-tool-to-detect-fragile-spine-fractures/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/chest-radiography-as-a-screening-tool-to-detect-fragile-spine-fractures/