Imaging of Osteoporotic Fractures on XR, CT, and MR

The evaluation of skeletal health has progressed from diagnostic labeling (normal-low bone mass-osteoporosis) to quantifying future fracture risk. Thus, the recognition of prevalent and incident fractures has increased in importance because they influence risk assessment. Non-spinal osteoporotic fractures rarely pose diagnostic problems, although those of the proximal femur and pelvis may require computed tomography (CT) and/or magnetic resonance imaging for diagnosis. Spinal fractures remain a paradox. Whereas radiological diagnosis in general benefits increasingly from powerful diagnostic tools to examine disease, many osteoporotic spinal fractures are asymptomatic, and their recognition is often incidental to chest radiography or body CT. Moreover, there are no uniformly agreed criteria by which to decide if a vertebra is fractured. Lastly, it has become apparent that some osteoporosis treatments may themselves contribute to so-called atypical femoral fractures.