Radiological criteria for atypical features of femur fractures: what we can learn when applied in a clinical study setting.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Erin S LeBlancEric Orwoll

Abstract

The paper focuses on the identification of atypical fractures (AFFs). This paper examines the concordance between objective classification and expert subjective review. We believe the paper adds critical information about how to apply the American Society of Bone and Mineral Research (ASBMR) criteria to diagnose AFFs and is of high interest to the field. Assess American Society of Bone and Mineral Research (ASBMR) criteria for identifying atypical femoral fractures (AFFs). Two orthopedic surgeons independently evaluated radiographs of 372 fractures, applying ASBMR criteria. We assessed ease of applying ASBMR criteria and whether criteria-based assessment matched qualitative expert assessment. There was up to 27% uncertainty about how to classify specific features. 84% of films were classified similarly for the presence of AFF according to ASBMR criteria; agreement increased to 94% after consensus meeting. Of 37 fractures categorized as AFFs based on ASBMR criteria, 23 (62.2%) were considered AFFs according to expert assessment (not relying on criteria). Only one (0.5%) femoral shaft fracture that did not meet ASBMR criteria was considered an AFF per expert assessment. The number of major ASBMR features present (four vs five) an...Continue Reading

References

Sep 16, 2010·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Elizabeth ShaneUNKNOWN American Society for Bone and Mineral Research
Jan 26, 2012·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Adrianne C FeldsteinEric Orwoll
May 29, 2013·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Elizabeth ShaneMichael P Whyte
Jan 21, 2016·The New England Journal of Medicine·Dennis M Black, Clifford J Rosen
Oct 21, 2016·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Robert A AdlerDeborah E Sellmeyer
Jul 22, 2017·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Erin S LeBlancEric S Orwoll

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Citations

Dec 16, 2019·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·N H RasmussenP Vestergaard
Dec 5, 2020·BMC Musculoskeletal Disorders·Joan C LoMonika A Izano
Feb 3, 2021·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Gareth CrouchChristian M Girgis

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