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Age: 47

Sex: Male

Indication: Back pain

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Case #32


Findings

  • Right eccentric T4 vertebral body height loss
  • No malalignment of the thoracic spine


Diagnosis

  • Compression fracture

Sample Report

  • Right eccentric T4 vertebral body height loss, consistent with age-indeterminate fracture. Recommend CT or MRI for further evaluation.
  • No malalignment of the thoracic spine.
  • Mild multilevel degenerative disc disease.


Discussion

  • T spine fractures are tough to pick up on x-ray, especially in the upper thoracic spine. Usually these are only ordered on adults when the ED physician has a very low suspicion for fracture, but it is a good idea to include a disclaimer saying something to the effect of “recommend cross-sectional imaging for further evaluation if there is ongoing clinical concern for fracture”


Images

Red arrow: subtle right eccentric T4 vertebral body height loss.

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