高齢者の脊椎新鮮圧迫骨折を見逃さないための初期像と座位・仰臥位単純Ｘ線撮影法

概要

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The objective of our study was to verify diagnostic accuracy of sitting and supine position radiography (S-S radiography) for early detection of fresh vertebral fractures in the elderly. To detect vertebral fractures mobility, lateral radiographs in sitting and supine position were performed on elderly patients (17 men, 77 women, mean age 80.3 years) complaining of acute trunk pain without a neurologic deficit. We studied the S-S radiography at the first clinical examination and additional magnetic resonance images (MRI) to diagnose fresh vertebral fractures. MRI detected 102 fresh vertebral fractures between T4 and L5 in 75 patients (15 men, 60 women, mean age 79.5 years). A correct diagnosis of incident fractures based on the S-S radiography was made in 90.7% of patients. Early detection of fresh fractures based on the S-S radiography in those vertebral fractures with fresh fracture based on MRI was made in 76.5% of all vertebral fractures. Diagnoses of fresh fracture based on Xp in those vertebral fractures with previous fracture based on MRI did not occur. We concluded that the S-S radiography at the first clinical examination was effective for early detection of fresh fractures in the elderly.
中国・四国整形外科学会の論文