The Hologic software then determined the anterior, posterior and middle vertebral body heights from the marker points and calculated the degree and type of vertebral shape anomalies, using the Genant classification, which is now considered the most appropriate method [12]. In this classification a relative height reduction (with reference to posterior-mid-anterior heights) between 20–25% was designated a “mild” fracture, 25–40% a “moderate” fracture, and >40% as a “severe” fracture [13–15]. Type of vertebral fracture could be “wedge” when the anterior height was the lowest, “biconcave” when middle height was the lowest or “crush” when posterior height was the lowest. The

original Genant classification, click here however, prescribes visual inspection and only measurements of those vertebrae that appear visually abnormal. However, we felt that this

approach leads to even more variability and unreliability as intra- and interobserver variability of visual radiological interpretation is considerable. Therefore, we chose to meticulously measure each vertebra with a Akt inhibitor visual quality check in all cases. Statistical analysis We decided to include 2,500 patients, which approximately amounts to a study duration of 2 years supported by our funding. We assumed that the precision of our main outcome parameter, the prevalence of vertebral fractures, would be sufficient with this sample size, and that approximately 2,500 patients would generate GANT61 chemical structure subgroups based on sex, BMD class, age group, affected vertebral level of sufficient size to allow reasonable precision of the prevalence estimates within such subgroups. Basically this study uses descriptive statistics only. The subgroup comparisons were based on Student’s t tests with p values of 0.05 as cutoff values. Univariate analysis was performed, but we refrained from multivariate analysis as predictive factors for vertebral fractures are sufficiently known and not the aim of this study. Statistical evaluations were performed using SPSS version 15 and Microsoft Excel software. Results Patients After the target inclusion

of 2,500 patients was reached, the study was stopped and the data were analyzed. Most patients were referred because of suspected secondary osteoporosis. Approximately two thirds of the group came for a first BMD measurement; in the remaining patients this was a follow-up MycoClean Mycoplasma Removal Kit test. Nearly one quarter of the patients had a recent low-energy fracture. More patient data are presented in Table 1. Table 1 Patient characteristics   Number SD Range Percent Total included 2,424       Sex           Male 851     35   Female 1,573     65 Postmenopausal women 1,240     51 Mean age (years) 53 15 18–94    Males (years) 50 15 18–87    Females (years) 54 15 18–94   Mean weight (kg) 74 15 33–150   Referring specialties           Orthopedics/Traumatology 613     25   Endocrinology 336     14   Systemic Diseases 288     12   General Intern. Med.