Bone Scintigraphy for Guidance of Targeted Treatment of Vertebral Compression Fractures

Elite Arnon-Sheleg, Daniel Weiner, Saeda Haj, Alon Rod, Nimrod Rahamimov

Research output: Contribution to journalArticlepeer-review


Background: Vertebral compression fractures (VCFs) are prevalent in the elderly population and might be the source of back pain if they are fresh and yet unhealed. In many cases, it is a diagnostic challenge to differentiate fresh VCFs from healed united fractures, which retain similar radiographic characteristics but no longer generate pain. This information is crucial for appropriate management. The aim of this study was to evaluate the role of bone scintigraphy (BS) in identifying fresh VCFs appropriate for targeted treatment when compared to the findings of Computerized Tomography (CT). Methods: We retrospectively reviewed 190 patients with back pain suspected to stem from a recent VCF that underwent both a CT and a BS and compared the imaging patterns per vertebra. Results: The studies were concordant in the majority of cases (95.5%), diagnosing 84.4% normal vertebrae, 6.4% acute VCFs, and 4.7% chronic VCFs. However, in 37 patients, 45 occult acute VCFs were only detected on BS and not on CT. Multivariate logistic regression analysis revealed that these patients were older and had lower bone density compared to the rest of the study population. Additionally, 40 patients had acute VCFs visible on CT, but with no increased or low intensity uptake on BS. These cases were associated with a shorter time period between trauma and BS, a higher prevalence of male patients, and a higher bone density. Acute VCFs with no increased uptake or low levels of uptake were found only within the first six days of the trauma. Conclusions: BS detects radiologically occult fractures and can differentiate if a radiographically evident VCF is indeed clinically active, guiding possible treatment options. To avoid missing acute VCFs, BS should be performed six days or more after the injury.

Original languageEnglish
Article number3627
JournalJournal of Clinical Medicine
Issue number12
StatePublished - 20 Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 by the authors.


  • bone scintigraphy
  • computed tomography
  • occult fracture
  • osteoporosis
  • vertebral compression fracture


Dive into the research topics of 'Bone Scintigraphy for Guidance of Targeted Treatment of Vertebral Compression Fractures'. Together they form a unique fingerprint.

Cite this