title: Clinical profile of acute vertebral compression fractures in osteoporosis.
abstract: Thirty patients with acute, painful vertebral compression fracture were studied. Certain vertebrae, namely T8, T12, L1 and L4, were more likely to fracture. The majority occurred spontaneously (46%) or after trivial strain (36%). Of the former, 30% occurred whilst in bed. Radiation to the flanks and anteriorly was common (66%) but leg radiation was uncommon (6%). Associated symptoms noted were: nausea (26%), abdominal pain (20%), chest pain (13%). Straining exacerbated pain in only 60%. The position of comfort was lying flat (43%) or sitting (36%) but 16% found standing or walking most comfortable. The correct diagnosis was made at the first visit in only 43% of patients. In the remainder there was a mean delay of 4.5 days before diagnosis. This poor diagnostic rate may be improved if other clinical features of osteoporosis such as kyphosis and a previous history of wrist and hip fractures are recorded, particularly when acute back pain occurs in bed. Full thoracic and lumbar X-rays may be required because pain and site of pathology may not coincide. Bone scanning may be necessary if immediate X-rays are normal. In early management the position of most comfort may be preferable to complete bed rest.
authors.affiliation: University Department of Medicine, Royal Infirmary, Glasgow.
authors.forename: U
authors.initials: U
authors.lastname: Patel
authors.forename: S
authors.initials: S
authors.lastname: Skingle
authors.forename: G A
authors.initials: GA
authors.lastname: Campbell
authors.forename: A J
authors.initials: AJ
authors.lastname: Crisp
authors.forename: I T
authors.initials: IT
authors.lastname: Boyle
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries