Evaluation of vertebral fractures on lateral chest radiographs of inner-city postmenopausal women

We assessed the prevalence of vertebral fractures as a marker for osteoporosis on lateral chest radiographs in inner-city, minority, postmenopausal women. We reviewed outpatient lateral chest radiographs on all women 55 years and older at an inner-city hospital during two randomly selected months, August 2000 and April 2002. There were 106 women with a mean age of 65 (range 55-89) years, 45 were Hispanic, 42 Black, 9 White, 10 of other ethnicity. Deformity was graded on a 0-3 scale with Grades 2 (moderate) and 3 (severe) deformities considered fractures. Interval lateral chest radiographs within 1-2 years were evaluated. Of the group 25% (26/106) had vertebral fractures. The fracture prevalence increased with age: 13% (17/54) of women under 65 years and 37% (19/52) of women 65 years and older had fractures (P < 0.05). The fracture was described as part of the radiographic report in only 15% (4/26) of the women. Of the group 15% (16/106) had interval lateral chest radiographs. Among those with interval lateral chest radiographs, 19% (3/16) developed new fractures. In this series 29% (31/106) of women were scheduled for bone density studies, but the studies were only completed in 6% (6/106). Lateral chest radiographs showed that vertebral fractures occurred commonly, increased with age, and progressed on follow-up. In a population of underserved minority women, the lateral chest radiograph provides an opportunity to identify women with osteoporosis for possible treatment.