A summary of our recent evidence-based works on radiographic diagnostics of prevalent osteoporotic vertebral fracture in older men and women

Endplatitis short vertebrae

“…Figure 1A also demonstrates that even when many SVa are already quite severe, they do not apparently ‘fracture’. In our osteoporotic fractures in men (MrOS) and women (MsOS) (Hong Kong) year-18 follow-up study ( 3 , 4 ), we noted that 14.2% of the older men (total n=155; mean age: 87.4 years) and 8.6% of the older women (total n=197; mean age: 85.2 years) had SVa. In a chest radiograph study with subjects of assumed normal bone strength, among in total of 449 men and women aged ≤34 years, no single case had SVa noted ( 5 ).…”

“…Short vertebrae of acquired cause (SVa) have been defined as the vertebral deformity with decreased vertebral anterior and middle heights, while without apparent anterior wedging or apparent bi-concave changes, i.e., middle height and anterior height are reduced to a similar extent, and without apparent radiographic endplate fracture ( 1 - 3 ). When diagnosing SVa, at least two adjacent short vertebrae (SV) in the same subject are required ( 1 , 3 ). SVa is a mimic of osteoporotic-like vertebral fracture (OLVF).…”

Schmorl’s node of primarily developmental cause and Schmorl’s node of primarily acquired cause: two related yet different entities

“…In a cohort of children who had suffered from stable compressive vertebral fractures, Möller et al (26) reported the occurrence of SN at advanced ages (40 years) at adjacent (2,30,31). The vertebral level distribution of SNa will be similar to traumatic vertebral fracture (high energy trauma) or OVF (low energy trauma) (19,32). less likely involve posterior portion of an endplate which is not a weak point of biomechanics.…”

“…(A) reproduced with permission from ( 17 ). (B,C) modified with permission from ( 19 ). SNa, Schmorl’s node of primarily acquired cause; CT, computed tomography; OVF, osteoporotic vertebral fracture.…”

“…The possible endplate weakness can be due notochord regression, ossification gaps, or vascular channels ( 2 , 30 , 31 ). The vertebral level distribution of SNa will be similar to traumatic vertebral fracture (high energy trauma) or OVF (low energy trauma) ( 19 , 32 ). SNa less likely involve posterior portion of an endplate which is not a weak point of biomechanics.…”