Biconcave vertebral fractures as a possible distinctive feature of indolent systemic mastocytosis compared with primary osteoporosis
Authors' conclusion
Multiple biconcave VFx are significantly associated with ISM and may help differentiate it from primary OP.
Study context
- Population
- Adults with vertebral fractures: Indolent systemic mastocytosis (ISM) vs primary osteoporosis
- Participants
- 66 adults
- Comparison
- Indolent systemic mastocytosis vs primary osteoporosis
- ISMn = 22
- Osteoporosis (OP)n = 44reference
- Outcome
- Prevalence of specific VFx morphologies (wedge or biconcave, Genant's criteria, lateral spine X-rays T4-L4) and their diagnostic value
Methodological detailseach ISM case compared with two controls with OP, adjustment for age and sex
- Each ISM case compared with two controls with OP
- Adjustment for age and sex
Main finding
As reported in the abstract
Proportion of biconcave VFx
| Group | Value | AUC (proportion of biconcave VFx) | AUC (number of biconcave VFx) |
|---|---|---|---|
| ISM | 80% | 0.919 | 0.878 |
| OP | 22% |
Value
ISM80%
OP22%
AUC (proportion of biconcave VFx)
ISM0.919
OP— not stated in the abstract
AUC (number of biconcave VFx)
ISM0.878
OP— not stated in the abstract
- ISM vs OP: P < 0.001
- Optimal cut-offs for distinguishing ISM from OP
- > 2 biconcave VFx or > 50% of total VFx
Observational data: associations, not effects.
Further findings
Age
P < 0.001
Male sex
P = 0.043
Median
| Outcome | ISM | OP | P value |
|---|---|---|---|
| Number of VFx | 4 | 3 | P = 0.039 |
Original publication
Biconcave vertebral fractures as a possible distinctive feature of indolent systemic mastocytosis compared with primary osteoporosis. Osteoporos Int. Published 10 December 2025. doi:10. 1007/ s00198-025-07799-1
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