Bone scintigraphy can diagnose osteoporotic vertebral compression fractures better than conventional radiography

Most difficult and very frequent complications of osteoporosis are vertebral compression fractures (VCF). Bone scintigraphy with ^99mTc-phosphonates enables early detection of vertebral compression fractures in the first 72 hours of occuring. Typical scintigraphic findings is markedly increased radiotracer uptake in the linear pattern, throughout collapsed vertebral body. Bone scintigraphy is usefull in follow-up of vertebral fractures healing, showing reduction of radiotracer uptake in fractured vertebrae. In patients with osteoporosis and suspition of VCF, we detected compression vertebral fracture by bone scintigraphy and compare it with conventional radiography findings.

Bone scintigraphy was done in 40 patients with osteoporosis and suspition of compression vertebral fractures, 32 women and 8 men, mean age, 71 years. Three hours after iv. injection of 740MBq of ^99mTc-DPD to the patients, a whole body scintigraphy was done. Standard radiographic views AP, lateral, and oblique were done in all patients.

Radiography findings were positive for vertebral compression fracture in 28 patients (70%), and with bone scintigraphy in 36 patients (90%). In one patient with healed-old vertebral fracture, with positive radiographic finding, scintigraphic finding was negative. Bone scintigraphy incidentally diagnosed bone metastases in 3 patients.

Bone scintigraphy has a very high sensitivity for detection of vertebral compression fractures in osteoporotic patients. Conventional radiography showed a much lower sensitivity and could not differentiate acute from old vertebral compression fractures.