  Introduction: This study evaluated algorithm-based qualitative (ABQ) method
for vertebral fracture (VF) evaluation with reference to semi-quantitative (SQ)
method and bone mineral density (BMD) measurement. Methods: Mr. OS (Hong Kong)
and Ms. OS (Hong Kong) represent the first large-scale cohort studies on bone
health in elderly Chinese men and women. The current study compared Genant's SQ
method and ABQ method in these two cohorts. Based on quantitative measurement,
the severity of ABQ method detected fractures was additionally classified into
grade-1, grad-2, and grade-3 according to SQ's deformity criteria. The
radiographs of 1,954 elderly Chinese men (mean: 72.3 years) and 1,953 elderly
Chinese women (mean: 72.5 years) were evaluated. Results: according to ABQ,
grade-1,-2,-3 VFs accounted for 1.89%, 1.74%, 2.25% in men, and 3.33%, 3.07%,
and 5.53% in women. In men and women, 15.7% (35/223) and 34.5% (48/139) of
vertebrae with SQ grade-1 deformity were ABQ(+, with fracture) respectively. In
men and women, 89.7% (35/39) and 66.7% (48/72) of vertebrae with ABQ grade-1
fracture had SQ grade-1 deformity. For grade-1 change, SQ (-, negative without
fracture) & ABQ (+, positive with vertebral cortex line fracture) subjects tend
to have a lower BMD than the SQ(+)& ABQ(-) subjects. In subjects with SQ
grade-2 deformity, those were also ABQ(+) tended to have a lower BMD than those
were ABQ(-). In all grades, SQ(-)&ABQ(-) subjects tended to have highest BMD,
while SQ(+)&ABQ(+)subjects tended to have lowest BMD. Conclusion: ABQ method
may be more sensitive to VF associated mild lower BMD than SQ method.
