TY - JOUR T1 - High prevalence of osteoporotic vertebral fractures in patients with Crohn’s disease JF - Gut JO - Gut SP - 654 LP - 658 DO - 10.1136/gut.51.5.654 VL - 51 IS - 5 AU - J Klaus AU - G Armbrecht AU - M Steinkamp AU - J Brückel AU - A Rieber AU - G Adler AU - M Reinshagen AU - D Felsenberg AU - C von Tirpitz Y1 - 2002/11/01 UR - http://gut.bmj.com/content/51/5/654.abstract N2 - Background and aims: Osteopenia and osteoporosis are frequent in Crohn’s disease. However, there are few data on related vertebral fractures. Therefore, we evaluated prospectively the prevalence of osteoporotic vertebral fractures in these patients. Methods: A total of 293 patients were screened with dual energy x ray absorptiometry of the lumbar spine (L1-L4) and proximal right femur. In 156 patients with lumbar osteopenia or osteoporosis (T score <−1), x ray examinations of the thoracic and lumbar spine were performed. Assessment of fractures included visual reading of x rays and quantitative morphometry of the vertebral bodies (T4-L4), analogous to the criteria of the European Vertebral Osteoporosis Study. Results: In 34 (21.8%; 18 female) of 156 Crohn’s disease patients with reduced bone mineral density, 63 osteoporotic vertebral fractures (50 fx. (osteoporotic fracture with visible fracture line running into the vertebral body and/or change of outer shape) and 13 fxd. (osteoporotic fracture with change of outer shape but without visible fracture line)) were found, 50 fx. in 25 (16%, 15 female) patients and 13 fxd. in nine (5.8%, three female) patients. In four patients the fractures were clinically evident and associated with severe back pain. Approximately one third of patients with fractures were younger than 30 years. Lumbar bone mineral density was significantly reduced in patients with fractures compared with those without (T score −2.50 (0.88) v −2.07 (0.66); p<0.025) but not at the hip (−2.0 (1.1) v −1.81 (0.87); p=0.38). In subgroups analyses, no significant differences were observed. Conclusions: In patients with Crohn’s disease and reduced bone mineral density, the prevalence of vertebral fractures—that is, manifest osteoporosis—was strikingly high at 22%, even in those aged less than 30 years, a problem deserving further clinical attention. ER -