ISCD Exam - VFA, AFF, TBS With Complete Solutions
What % of Fx are unappreciated on X-ray? 2/3 (only 10% required admission to the
hospital)
Vertebral Fracture Assessment (VFA)
- What is it?
- Allows for what? Thorocolumbar spine in imaged to detect vertebral fractures using
DXA
Allows integration of BMD with presence of vertebral fracture for diagnosis, fracture
risk assessment, and pain management
Spine X-ray vs VFA: Higher or lower?
- Effective radiation dose X-ray: 1800-2000 uSv
VFA: 30-50 uSv
Spine X-ray vs VFA: Access - Answer X-ray: Separate visit
VFA: Point of service
Spine X-ray vs VFA: Cost - Answer X-ray is more expensive than VFA
Spine X-ray vs VFA: Resolution - Answer X-ray has higher resolution than VFA
Spine X-ray vs VFA: Visualization - Answer X-ray is superior above T7
, General Positioning for Lateral VFA Scans - Answer Place patient in decubitus position
with back parallel to scanner
Shoulders perpendicular to scanner bad
Knees and hips at 90 degree angles
Bolsters between knees to level top peg
General Positioning for PA VFA Scans - Answer Patient remains in supine position as for
PA spine DXA (mid-line of patient over mid-line of table)
Shoulders and pelvis flat on the table surface
Identifying Verebrae for VFA Scans - Answer Start low enough to see L5-S1 (L4-L5
junction is normally near the iliac crest; ribs are usually seen over anterior aspect of L1)
Identify L5
Count from L5 up, adjusting contrast as needed
In a normal VFA scan, thoracic vertebrae often look slightly ______ and lumbar vertebrae
often look slightly ______ - Answer wedged, biconcave
4 Limitations of VFA - Answer Not all vertebrae may be adequately visualized
Artifacts may interfere with visualization
What % of Fx are unappreciated on X-ray? 2/3 (only 10% required admission to the
hospital)
Vertebral Fracture Assessment (VFA)
- What is it?
- Allows for what? Thorocolumbar spine in imaged to detect vertebral fractures using
DXA
Allows integration of BMD with presence of vertebral fracture for diagnosis, fracture
risk assessment, and pain management
Spine X-ray vs VFA: Higher or lower?
- Effective radiation dose X-ray: 1800-2000 uSv
VFA: 30-50 uSv
Spine X-ray vs VFA: Access - Answer X-ray: Separate visit
VFA: Point of service
Spine X-ray vs VFA: Cost - Answer X-ray is more expensive than VFA
Spine X-ray vs VFA: Resolution - Answer X-ray has higher resolution than VFA
Spine X-ray vs VFA: Visualization - Answer X-ray is superior above T7
, General Positioning for Lateral VFA Scans - Answer Place patient in decubitus position
with back parallel to scanner
Shoulders perpendicular to scanner bad
Knees and hips at 90 degree angles
Bolsters between knees to level top peg
General Positioning for PA VFA Scans - Answer Patient remains in supine position as for
PA spine DXA (mid-line of patient over mid-line of table)
Shoulders and pelvis flat on the table surface
Identifying Verebrae for VFA Scans - Answer Start low enough to see L5-S1 (L4-L5
junction is normally near the iliac crest; ribs are usually seen over anterior aspect of L1)
Identify L5
Count from L5 up, adjusting contrast as needed
In a normal VFA scan, thoracic vertebrae often look slightly ______ and lumbar vertebrae
often look slightly ______ - Answer wedged, biconcave
4 Limitations of VFA - Answer Not all vertebrae may be adequately visualized
Artifacts may interfere with visualization
