Opportunistic Diagnosis of Osteoporosis through CT Pulmonary Angiography for Suspected Pulmonary Embolism.

BACKGROUND

CT pulmonary angiography (CTPA) ordered to confirm or exclude pulmonary embolism (PE) often reveals incidental findings. Its yield in the opportunistic detection of osteoporosis, a prevalent, under-diagnosed condition, is less clear.

AIM: Evaluate osteoporosis and fragility fractures in CTPAs.

DESIGN

Retrospective review of consecutive CTPAs, compared to the initial imaging report and previous diagnosis.

METHODS

CTPAs review by a consultant radiologist and pertinent clinical data from patients' charts.

RESULTS

A total of 517 CTPAs (52.6% women, median 70-years-old) were included. PE was identified in 19%. Varied other significant findings were identified, either acute or incidental. Osteoporosis was more than twice as common as PE, found in 211/517 (41%), but it was previously known in 20/211 (4%) and treated in 8 (1.5%). One quarter of the patients with osteoporosis had fragility fractures in the thoracic vertebrae (53/211, 10% of the entire cohort). The primary radiological report named osteoporosis in only 9/211 (1.5%) and fragility fractures in 3/53 (5.5%).

CONCLUSION

CTPA can be routinely applied to include evaluation of the vertebral column for osteoporosis, a prevalent and notoriously underdiagnosed and undertreated serious condition of older adults.