Vertebral Fractures as Osteoporosis Markers: Detecting and Managing Underdiagnosed Fragility

Osteoporotic vertebral fractures are common, often silent, and independently predict future fractures. Opportunistic CT, DXA vertebral fracture assessment, and AI-assisted detection can improve case finding. Integrated management including anabolic-first therapy for high-risk pa…

• Osteoporotic vertebral fractures frequently occur without osteoporosis-range BMD and remain underdiagnosed on routine imaging.
• Fracture Liaison Services offer a system-level model to close the diagnosis and treatment gap after a sentinel fracture.
• Patients with recent or multiple vertebral fractures often meet criteria for very-high fracture risk, warranting anabolic-first or sequential therapy.

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