Diagnóstico de osteoporosis mediante la radiografía lateral de tóraxDiagnosis of osteoporosis by lateral chest X-ray

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Fundamento

La radiografía lateral de tórax, mediante la detección de deformidades vertebrales, puede ayudar a identificar tempranamente a los enfermos con esteoporosis. En este trabajo hemos querido ver con qué frecuencia los radiólogos refieren en sus informes de radiografías laterales de tórax algún dato que permita al clínico sospechar una osteoporosis, y en qué porcentaje de casos el clínico, ante estos informes, llega a diagnosticar la enfermedad.

Pacientes Y método

Se han revisado los informes de las radiografías laterales de tórax de 3.500 pacientes consecutivos, así como sus informes de alta.

Resultados

Los informes radiológicos hicieron referencia a la existencia de osteoporosis sólo en un 20% de los casos potencialmente diagnosticables; los informes clínicos lo hicieron en un 6,3% (un tercio de los casos con informe radiológico positivo); sólo se trató adecuadamente al 4% (dos tercios de los casos diagnosticados por el clínico).

Conclusiones

La osteoporosis es una enfermedad desatendida por radiólogos y clínicos. Las radio-grafías laterales de tórax constituyen una herramienta diagnóstica desaprovechada en la identificación de pacientes con osteoporosis.

Background

Lateral chest X-rays may be helpful in the early detection of osteoporotic patients. We studied the proportion of chest X-ray reports in which the radiologist highlighted the presence of vertebral osteoporotic signs, as well as the proportion of patients with such records who were further studied by their physicians in order to confirm the diagnosis of osteoporosis.

Patients and method

We reviewed both lateral chest X-ray records of 3,500 consecutive patients and their medical records with the ultimate diagnosis.

Results

Radiology reports referred to the presence of vertebral abnormalities suggestive of osteoporosis in only 20% of potentially expected cases. Final medical records registered a diagnosis of osteoporosis in only one third of «positive» radiological records (6.3% of expected cases with vertebral abnormalities). Only two thirds of patients diagnosed with vertebral osteoporosis by their physician were adequately treated (4% of «positive» lateral chest X-ray reports).

Conclusion

Osteoporosis is a disease overlooked by both radiologists and clinicians. Lateral chest X-ray is a helpful diagnostic tool for osteoporosis but its usefulness is often missed.

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