Osteoporotic Vertebral Fracture on CT and Bone Scan: The Critical Imaging Finding Every Clinician Should Recognize
Clinical Presentation A 68-year-old woman arrives at the emergency department with severe mid-back pain that began after lifting a light grocery bag. She denies any major trauma. Initial radiographs show only mild vertebral deformity. Many clinicians might reassure her and prescribe analgesics. But the pain worsens. A sagittal CT reveals a T12 burst fracture, and Tc-99m MDP bone scintigraphy demonstrates intense linear radiotracer uptake at the same level, confirming an active osteoporotic fracture. This scenario illustrates one of the most common yet frequently underdiagnosed causes of disability among older adults: osteoporotic vertebral fracture. Early recognition is essential because delayed diagnosis can lead to progressive kyphosis, chronic pain, respiratory compromise, repeated falls, and increased mortality. Learning Objectives After reading this article, readers will be able to: Understand the pathophysiology of osteoporotic vertebral fractures. Recognize characteris...
