The accuracy of clinical kyphosis examination for detection of thoracic vertebral fractures: comparison of direct and indirect kyphosis measures

摘要

Objective: To compare the accuracies of two simple physical examination maneuvers for detecting the presence of thoracic vertebral fractures (VF) diagnosed by radiography: direct measurement of kyphosis angle (KA, in degrees) and indirect measurement using wall-occiput distance (WOD, in cm). Methods: Subjects were 280 women (average age, 54.5 years; range, 18-92) referred for assessment of osteoporosis. KA was measured from T4 to T12 using a digital inclinometer while WOD was measured with the patient in a standardized position. VF were diagnosed on radiographs using semi-quantitative morphometry. Results: KA and WOD were moderately correlated (r=0.72, p4.0 cm as an indication to consider spine radiography. At this WOD threshold, sensitivity was 41% (95% CI, 31-52%) and specificity was 92% (95% CI, 87-95%). WOD should be considered for use in the clinical assessment of osteoporosis patients