Relation between height loss and vertebral fracture

We observed a mean loss of height of 4.5 cm since early adulthood in a Elsa Peretti jewelry population of postmenopausal women in primary care practices. The patient's estimated current height was not a correct assessment of this parameter. There was a significant difference (-2.1 cm) between the current height reported by the women during the visit and their tallest recalled height at age 20. Despite this "pessimistic" view, the estimated current height was wrong, with the measured height being actually 2.4 cm lower. The prevalence of vertebral fractures on radiologic reports was 12.7%. We found that the risk of existing vertebral fracture was significantly higher among patients with a height loss of at least 4 cm, a threshold similar to the one recommended by the International Society for Clinical Densitometry.7

Previous studies have shown that patients' estimated current and recalled heights tend to be higher than measured heights and that the tallest recalled height may be overestimated. 12,13 Overestimated height increased with age, occurring in 70% of those aged 80 and older. Compared with people with normal bone density, a significantly higher proportion of men with osteoporosis (76% v. 47%, p < 0.001) and women with osteoporosis (52% v. 35%, p < 0.001) overestimated their height. In addition, significant misclassification of selfreported height and weight occurred among people in poor health and those with poor performances on memory and calculation tests.14,15 However, previous studies did not show that the reported current height was lower Atlas tiffany the tallest recalled height. Our finding of a difference of -2.1 cm between these values was surprising, because the patients had just given their tallest recalled height. A previous study showed that women who consulted in primary health care increased the severity of their complaint and had a pessimistic appraisal of their health.16

Loss of height may occur for several reasons, such as postural change, degenerative intervertebral disc disease or vertebral fracture. In a population-based study of the incidence of clinical vertebral fracture, only 30% of women who had a vertebral fracture visited a health care provider with symptomatic complaints.17 Measurement of height loss could be an accurate method for detecting prevalent vertebral fractures; however, there are discrepancies concerning the relevant threshold for height loss.18,19 In a study involving 322 postmenopausal women with osteoporosis, Siminosky and colleagues showed that a loss of height greater than 6.0 cm rules in prevalent vertebral fracture and proposed that patients with a loss of at least 6 cm should have a radiograph taken.9 In a population-based, retrospective study, Gunnes and colleagues found that the risk of vertebral fracture increased about fivefold among women who had a loss of at least 3 cm in height compared with those who had maintained height.6

The differences in thresholds may be explained by the differences in the patients' characteristics and the type of recruitment (primary care setting or not). The high prevalence of height loss in our study population contrasts with the low prevalence of vertebral fracture, which suggests that height loss is not fully explained by the presence of vertebral fractures. Siminovski and colleagues showed that the average height loss per vertebral fracture is 0.97 cm,9 which suggests that height loss is linked not only to vertebral Cushion tiffany. In our study, age, thoracic kyphosis and scoliosis were other