Radiologists are underreporting vertebral fractures; causing them to miss opportunities to diagnose and treat osteoporosis as well as lessen the risk of subsequent fractures.

These were the findings of a new retrospective study conducted by a team of researchers at the University of Oxford.

Osteoporosis is the culprit behind more than 8.9 million fractures globally per year, according to the International Osteoporosis Foundation. A prior fracture is associated with an 86 percent elevated risk of a subsequent fracture.
Data from the local Fracture Liaison Service was used to find the 732 hip fracture patients over age 50 who visited the hospital in 2013. They then identified 157 patients who also underwent thoracic and/or lumbar spine imaging exams in the last six years.

Many of the imaging studies showed incidental vertebral fractures, but 54 percent were not reported by the radiologists. Only 25 percent of the patients identified with vertebral fractures were on osteoporosis therapy at the time of injury.

The underreporting problem was particularly prominent among radiologists who aren’t specialized in musculoskeletal imaging. They account for 91 percent of the unreported vertebral fractures.

Dr. Ruth M. Mitchell of the University of Oxford stressed the importance of radiologists being vigilant during routine imaging for the presence of vertebral fractures, especially in elderly patients. It’s just as important to have an effective referral system in place so these patients are directed to fracture prevention services.

Not only does underreporting put patients at risk of life-threatening hip fractures, it also presents a major cost issue. In the U.K., hip fractures account for at least £1.1 billion in hospital costs.

“We believe that, together, this will increase the number of patients receiving effective osteoporosis therapy, protecting against future hip fractures and the associated mortality, morbidity and cost,” Mitchell said in a statement.

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