{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:46:41Z","timestamp":1791953201068,"version":"4.3.4"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Silent vertebral fractures are common but under-recognised. We aimed to estimate the prevalence in an asymptomatic population and to identify demographic and clinical predictors using the UK Biobank data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>DXA spine images from 2446 asymptomatic UK Biobank participants aged 40\u201379 years were analysed retrospectively. Vertebral fractures were defined as moderate or severe deformities (\u2265\u200925% vertebral height loss). Fractures were identified using an artificial-intelligence-assisted six-point morphometric algorithm with manual correction and radiologist confirmation. Associations with age, sex, bone mineral density (BMD), body mass index (BMI), medication, and back pain were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2446 participants (mean age 62.0\u2009\u00b1\u20097.4 years; 1151 men) were analysed. Moderate or severe vertebral fractures were identified in 356 participants (14.6%). Prevalence increased with age, from 9.4% in participants aged 40\u201349 years to 19.6% in those aged 70\u201379 years. Fractures were more common in men than women (18.8% vs. 10.8%; adjusted OR 0.51 for women vs. men, 95% CI 0.40\u20130.66;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). BMD and most conventional clinical risk factors had limited predictive value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Silent vertebral fractures are common in midlife, frequently occur in individuals with normal bone density, and are more prevalent in men. Conventional clinical risk factors have a limited ability to identify affected individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Silent vertebral fractures are frequently overlooked in asymptomatic individuals, and their prevalence and demographic distribution in middle-aged adults are not well-characterised<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>In a large asymptomatic cohort, vertebral fractures were common, showed male predominance, and were frequently present in individuals without low bone mineral density or recognised clinical risk factors<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Silent vertebral fractures are prevalent in asymptomatic adults and are poorly captured by conventional risk assessment, indicating limitations of current approaches to fracture identification<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12947-0","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:54:09Z","timestamp":1791921249000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and predictors of silent vertebral compression fractures using DXA: a UK Biobank Imaging Study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7034-5421","authenticated-orcid":false,"given":"David John","family":"Wilson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard William","family":"Whitehouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina Marian","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Saunders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Abel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"12947_CR1","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/S0140-6736(02)08761-5","volume":"359","author":"JA Kanis","year":"2002","unstructured":"Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. 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Iain Wilson is affiliated with Oxehealth. David Wilson, Richard Whitehouse, Georgina Allen, Fiona Saunders, and Richard Abel declare no other competing interests.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Statistical advice was provided by Dr John Pinney (Imperial College London) and Dr Paul Bassett.","order":3,"name":"Ethics","label":"Statistics and biometry","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Written informed consent was not required for this study because the data were obtained from the UK Biobank, and all participants had consented to the anonymised use of their data. The appropriate ethics committee waived consent requirements.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"UK Biobank has full ethical approval from the National Information Governance Board for Health and Social Care and the North-West Multi-Centre Research Ethics Committee (11\/NW\/0382). Permission to access and analyse UK Biobank data for this study was approved under UKB application number 17295. The Imperial College London Bone Laboratory holds regular Patient in Research meetings to discuss the project\u2019s nature and findings with the patient panel. This project was discussed at a meeting in 2019.","order":5,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Some participants included in this analysis have been reported previously in other UK Biobank imaging studies, including the AUGMENT study.","order":6,"name":"Ethics","label":"Study subjects or cohorts overlap","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"order":7,"name":"Ethics","label":"Methodology","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}