This study examined 144 sequentially selected female patients with a mean age of 53.4 years. The purpose was to assess whether instant vertebral assessment (IVA) and lateral DEXA bone mineral density (BMD) measurement in the lumbar spine would render a significant difference in the assessment of bone loss compared with the older conventional PA measurement only. Thirty-five per cent of our patients' bone loss had to be upgraded because of the lower BMDs found on lateral DEXA scanning of the lumbar spine than was shown on PADEXA studies. Using the Genant classification, asymptomatic vertebral fractures were found in 10% of osteopaenic patients and in 26% who had osteoporosis with lateral IVA assessment. It was therefore concluded that both of these modalities were useful and made a greater contribution in the assessment of bone density loss, therefore enabling a more appropriate treatment protocol to be instituted and also improving patient compliance. The latter occurred because patients would rather accept a visual image of their illness such as a spine fracture or BMD value visually displayed on a graph than a verbal explanation for their asymptomatic but serious disease.

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