Attending Version: Back Pain Emergencies Module; created by Dr. Wendy Gerstein


What should be your next step in evaluating this patient?



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What should be your next step in evaluating this patient?
Plain films were obtained at the 3rd ER visit which showed compression fracture of T6 with 50% loss of height.
Now what?
This patient needs further evaluation for underlying etiology of compression fracture, with malignancy being highest on the differential. Patient has risk factors for lung cancer (smoking), multiple myeloma (Agent Orange exposure), pancreatic (family h/o, tobacco abuse), prostate (sex, age).

CT scan of thoracic spine revealed a T6 pathologic fracture extending into the pedicles and cortical breakthrough with surrounding peri-vertebral hematoma, no spinal cord compromise.




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