Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit

Published Date: 29th September 2023

Publication Authors: Retnasingam G

Aim
To describe a UK-wide re-audit of the 2019 Royal College of Radiologists (RCR) audit evaluating patient-related data and organisational infrastructure in the radiological reporting of vertebral fragility fractures (VFFs) on computed tomography (CT) studies and to assess the impact of a series of RCR interventions, initiated to raise VFF awareness, on reporting practice and outcomes.

Materials and Methods
Patient specific and organisational questionnaires largely replicated those utilised in 2019. The patient questionnaire involved retrospective analysis of between 50 and 100 consecutive, non-traumatic CT studies which included the thoracolumbar spine. All RCR radiology audit leads were invited to participate. Data collection commenced from 1 April 2022.

Results
Data were supplied by 129/194 (67%) departments. One thousand five hundred and eighty-six of 7,316 patients (21.7%) had a VFF on auditor review. Overall improvements were demonstrated in key initial/provisional reporting results; comment on spine/bone (93.2%, 14.4% improvement, p<0.0002); fracture severity assessment (34.7%, 8.5% improvement, p=0.0007); use of recommended terminology (67.8%, 7.5% improvement, p=0.0034); recommendations for further management (11.7%, 9.1% improvement, p<0.0002).

Conclusions
The 2022 national re-audit confirms improvements in diagnostic performance and practice in VFF reporting. Continuing work is required to build on this improvement and to further embed best practice.

 

Howlett, DC; Retnasingam, G et al. (2023). Radiology reporting of incidental osteoporotic vertebral fragility fractures present on CT studies: results of UK national re-audit. Clinical Radiology. 78(12), pp.E1041-1047. [Online]. Available at: https://doi.org/10.1016/j.crad.2023.09.004 [Accessed 12 January 2024]

 

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