Page 39 - MRS Abstracts March 2023

The data collected included: patient’s unit number, age, referrer details, type of imaging recommended on the DXA report, reason for imaging, whether the imaging was performed and relevant findings.
Results:
35 patients were included. Spinal X-rays were recommended in 32 patients and MRI scans recommended in 3 patients. Most of the patients where further imaging was recommended came from General Practice however there was a spread across multiple secondary care specialities. The commonest reasons for imaging requests were high bone density, height loss and increased bone density in individual vertebrae.
Out of 35 requests for further imaging following DXA scan, 10 patients attended for imaging (29%). Of the 10 Xrays/MRI scans which were done, 2 revealed new fractures (20%).
Conclusions:
The previous report wording left the requesting clinician to decide if further imaging was warranted rather than emphasizing that the patient should be referred for imaging. However, this relies on the clinician reviewing the patient’s notes again/contacting the patient after the initial consultation (time consuming). When further imaging had been arranged, 20% of patients were found to have new vertebral fractures, which could change their osteoporosis management and increase their risk of further fracture.
More patients should therefore be offered imaging to detect previously undiagnosed vertebral fractures. As a result of this project, the DXA quick codes have been altered so imaging information appears in bold and reports are now 39ndividualized more frequently to make reasons for further imaging clearer to the referring clinician.
Key points:
• New fractures were detected in 20% of patients who underwent recommended imaging following DXA scan, which could change patient management.
• Wording on DXA reports has now been altered and written in bold so the reasons for further imaging are clearer to the referring clinician.
• There is likely to be a large number of patients in the community with undiagnosed vertebral fractures. A fracture liaison service would be a very good way to increase detection of these fractures.