Prediction of fragility fractures

Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up study

Giovanni Adami1, Giovanni Arioli2, Gerolamo Bianchi3, Maria Luisa Brandi4, Carla Caffarelli5, Luisella Cianferotti4, Davide Gatti1, Giuseppe Girasole3, Stefano Gonnelli5, Monica Manfredini2, Maurizio Muratore6, Eugenio Quarta6, Laura Quarta6

Published: Bone. 2020 May;134:115297

Highlight:

The identification of patients at risk for fragility fractures who may benefit from osteoporosis treatments is a challenge to clinicians. With this prospective observational study, the authors investigated the effectiveness of the T-score values provided by Radiofrequency Echographic Multi-Spectrometry (REMS) in the identification of patients at risk for incident osteoporotic fractures, comparing the performance of REMS with the Dual-energy X-ray Absorptiometry (DXA) one in a 5-years follow-up.

The studied population were over 1500 women from 30 to 90 years old who underwent REMS and DXA scans at femoral and vertebral sites. Among the findings of this study, a high agreement between REMS- and DXA-measured bone mineral density (BMD) values was observed. As concerning fragility fractures, a relationship between lower T-score values and higher fracture rate was observed, as expected.

Considering the reference T-score threshold value of −2.5 to distinguish between osteoporotic and non-osteoporotic patients, REMS showed higher sensitivity than DXA at the vertebral site in the identification of incident fragility fracture (65.1% versus 57.7%, respectively), whereas the performance were comparable between techniques for the femoral site. REMS T-score resulted an effective predictor of the occurrence of incident fragility fractures, representing a valuable approach to enhance osteoporosis diagnosis in clinical routine.

1 Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
2 Department of Neurosciences and Rehabilitation, “Carlo Poma” Hospital, ASST-Mantova, Mantova, Italy
3 SC Rheumatology, ASL 3 Genovese, Genoa, Italy
4 Department of Experimental and Clinical Biomedical Sciences, University of Florence, Metabolic Bone Diseases Unit, University Hospital of Florence, Florence, Italy
5 Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
6 O.U. of Rheumatology, “Galateo” Hospital, San Cesario di Lecce ASL-LE, Lecce, Italy