Prevalence of vertebral fractures and minor vertebral deformities evaluated by DXA-assisted vertebral fracture assessment (VFA) in a population-based study of postmenopausal women: the FRODOS study.

UNLABELLED: Population-based studies performed with vertebral fracture assessment (VFA) morphometric technology are lacking in postmenopausal osteoporosis. In this study, we show a lower than expected prevalence of vertebral fractures, a high prevalence of minor vertebral deformities, and a clear association with clinical and densitometric parameters indicating the usefulness of this approach. INTRODUCTION: Adequate epidemiological data on the prevalence of vertebral fractures (VF) is essential in studies of postmenopausal osteoporosis. Routine DXA-assisted VFA may be useful to determine the presence of VF. However, population-based studies performed with this technology are lacking. We aimed to assess the prevalence of VF and minor deformities in 2,968 postmenopausal women aged 59-70 years from a population-based cohort. METHODS: VFA and bone mineral density (BMD) measurements were conducted, and McCloskey criteria (vertebral heights under 3 SD from reference values) confirmed with the Genant method were used to define VF. Additionally, minor vertebral deformities (vertebral heights between -2 and -2.99 SD) were evaluated. RESULTS: The prevalence of VF was 4.3%, and 17% of the participants had minor vertebral deformities. Low BMD was frequently observed in women with VF, with 4%, and 42% of participants showing osteoporosis and osteopenia. Minor vertebral deformities were observed in nearly 40% of women with VF. Multivariate logistic regression analysis showed that age, history of previous fracture, osteoporotic BMD, receiving anti-osteoporotic treatment, and current use of glucocorticoids were significantly associated with VF. CONCLUSIONS: Although the VFA approach showed a lower than expected prevalence of VF in our cohort, its association with clinical and densitometric parameters may be useful to identify women at risk for developing fragility fractures and may therefore justify its use in longitudinal studies. The high prevalence of minor vertebral deformities detected in patients with VF indicates the need to evaluate this type of deformity as a risk factor for further skeletal fractures.

The "target sign": is it a specific sign of CNS tuberculoma?

In brain lesions, the target sign has been defined as a central nidus of calcification or central enhancement surrounded by a ring of enhancement. It has been considered a pathognomonic finding of central nervous system (CNS) tuberculoma. The purpose of this report is to demonstrate that the target sign related to central enhancement is a nonspecific finding and may lead to erroneous diagnosis of CNS tuberculoma.

Ictus isquémico en paciente joven hipertensa: displasia fibromuscular arterial en territorio cerebral y renal / Ischemic stroke in a young hypertensive patient: Arterial fibromuscular dysplasia in brain and kidney territories

Describimos un caso de hipertensión arterial secundaria a displasia fibromuscular (DFM) de la arteria renal que debutó con afectación vertebrobasilar en forma de accidente cerebral vascular isquémico. La DFM de la arteria renal es una de las causas principales de hipertensión secundaria o renovascular. Es muy frecuente en pacientes jóvenes, de sexo femenino y se caracteriza por su imagen angiográfica arrosariada. Es una de las causas de hipertensión arterial con un tratamiento potencialmente definitivo, ya sea percutáneamente o por cirugía de la arteria renal. La localización más frecuente es la arteria renal, aunque puede afectar otros territorios vasculares; el más comúnmente afectado, como en nuestro caso, es el cerebrovascular (AU)

We present the case of hypertension secondary to renal artery fibromuscular dysplasia that initiated with vertebrobasilar disease in form of ischemic vascular cerebral accident. Renal artery fibromuscular dysplasia is one of principal cases of secondary or renovascular hypertension. It tends to affect young women patients and is characterized by its typical “string of beads” appearance on the angiogram. It is one of the causes of arterial hypertension that can be treated with revascularization percutaneous transluminal angioplasty or surgical revascularization. Its most frequent location is the renal artery, but it has been described in almost every arterial bed in the body. In our case, the cerebrovascular territory is affected (AU)