Incidentally detected vertebral fractures and risk of myeloma: a prospective cohort study of 9059 CT-scanned Danish general population individuals

Abstract

Vertebral fractures are frequently detected incidentally on computed tomography (CT) scans performed for other indications in individuals with no symptoms of a fracture [ 1 ]. In myeloma, >45% of patients have vertebral fractures at the time of myeloma diagnosis [ 2 ]. However, the risk of myeloma in individuals with incidentally detected vertebral fractures is unknown. This lack of evidence has led to a controversy reflected in clinical guidelines, as some recommend evaluation for myeloma by measuring M-protein and kappa/lambda free light chains in all individuals with non-traumatic vertebral fractures [ 3 , 4 ], while other guidelines recommend evaluation only if symptoms or other findings raise suspicion of myeloma [ 5 ].