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Spine X-ray better than a DEXA scan

Spine X-rays should be used instead of DEXA scans to identify people at risk from vertebral fractures, a UK study suggests.

Using data from the European Prospective Osteoporosis Study, researchers found they could predict risk using a simple questionnaire but that specificity was not good enough for clinical practice.

Addition of DEXA scanning did not usefully improve the predictive value of the algorithm. But adding in X-ray data improved the sensitivity of predicting one or more fractures by four-fold with a specificity of 90 per cent.

The researchers, from the University of Cambridge, proposed that GPs use a score on the basis of age, weight, height loss and history of fracture to decide on use of X-ray.

The results can then be used to determine a patient's risk and make treatment decisions, concluded the study, published online by Osteoporosis International.

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