Osteoporosis: Spine

Kyle Walsh
Midwestern State University
RADS-4733-X31
Rodney Fisher
17 July 2017
 Osteoporosis

Osteoporosis occurs when the body breaks down more bone than it replaces in the remodeling process. The result is bone
that appears “porous” and has a much lower bone mass and density. It most commonly effects postmenopausal women but
can also effect premenopausal women and man. It effects bones that have more cancellous bone like the vertebrae or the
femur. The two types of osteoporosis are primary (postmenopausal, senile or idiopathic) and secondary (affecting men and
women after a primary disorder such as Cushing's syndrome).
 Diagnostic Procedures

For CT and MRI scans of the spine of someone with osteoporosis, contrast is not usually used as
radiologists are usually just using these modalities to view fractures which are caused by the patients
condition. The area of interest is the spinal cord. People with osteoporosis most commonly fracture
bones in the thoracic section of the spinal cord, but fractures can occur from the cervical section all
the way down to the sacrum. In both MRI and CT, a lateral image is obtained first in most cases. You
want to make sure the spine is parallel with the film. The most important thing is to make sure the
patient is not uncomfortable. Especially with an MRI where they may be in that position for a while.
Laying them down on their stomach may be the most comfortable position for them but this varies
from patient to patient depending on where the fracture may be.
 CT Comparison
Normal Osteoporotic
 MRI Comparison
Normal Osteoporotic
 Conclusion

For treatment of osteoporosis I believe MRI is a better tool for radiologists. MRI is much more detailed and
can detect very slight details that CT cannot such as tissue damage in result to a spinal compression
fracture. However, neither scan is actually the preferred standard for diagnosing osteoporosis. While they
both can prove as useful tools for radiologists in treating the results of osteoporosis such as fractures,
bone densitometry (DEXA) is the gold standard for diagnosing and assessing overall progression of
osteoporosis. Most of the time, MRI and CT are used to scan for fractures which are a result of
osteoporosis but once doctors expect that someone is osteoporotic, they like to do a DEXA to get a better
idea of the overall bone regression. DEXA scans are better at monitoring just how porous a patients bones
are and how much density they have lost.
 References

Bashir, U. (2017). Osteoporotic Spinal Compression Fracture. Retrieved from: https://radiopaedia.org/articles/osteoporotic-spinal-

compression-fracture

Kelley, L. L., Petersen, C.M. (2013). Sectional Anatomy. Elsevier.

Schubert, R. (2017). Osteoporotic Vertebral Fractures- Recent and Old. Retrieved from: https://radiopaedia.org/cases/osteoporotic-

vertebral-fractures-recent-and-old

Vanmeter, K. C., Hubert, R. J. (2014). Gould’s Pathophysiology for the Health Professions. Elsevier.