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Diagnosing Vertebral Fractures
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megmo84 posted:
What is the accuracy of CT scans in diagnosing vertebral fractures?

Dull back pain recently sent me to the ER in fear that I had fractured. Fortunately, the CT scan showed no fracture. The pain was short-lived and attributed to a pulled muscle. Nevertheless, the experience has left me rattled. Knowing for sure that my CT results were correct would be a great comfort.
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bonebabe responded:
I think it depends on the location and severity of the fracture. I've known people who had CT scans and were told there was no fracture, and then again, people who had no idea they'd fractured were told yes, they had after having a CT scan.

If it's time for you to have a DXA, I'd suggest you also ask your doctor about having a VFA or Vertebral Fracture Assessment. That would give you a definitive answer. The VFA is not done separate from the DXA, so unless it's time for your bone density scan, that wouldn't be an option.

Usually a compression fracture has pain that worsens instead of lessens. If your pain was short lived and you had a negative CT scan, I'd believe it was a muscle.
 
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Anon_238569 responded:
I thought I had broken my foot. It never showed up on a x/ray.
I went with it like this for 4 days, could not put it down, on 6th day had to go back to work and be on my feed 4 hours a day. Finally after much complaining and swelling, the Dr. did a MRI and it was broken. It never showed up on X-Ray. I still have much trouble. I think if they would have sent me for MRI first, I would have been spared 2 bottles of pain medicine and much pain. Thanks.
 
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Engineerbill replied to Anon_238569's response:
I fell in my bathroom, bumping the top of my head and hurting my back (no bruises). I treated the bump with ice and the swelling and pain disappeared, but I still had back pain. I saw a spine specialist who, in cavalier fashion, took two X-rays, said nothing was broken, that I had only a sprained muscle, prescribed some Vicodin and said to see him again in a month. The back pain continued to get worse over the next couple of weeks so I called my GP and asked to have an MRI. It showed I had compression fractures at vertebrae T-8 and T-9. Since I had developed sepsis from an infected PICC line and was running a 104-degree fever at the time of the fall, we found later that the infection had entered the bone marrow of the vertebrae and the infection (later found to be MRSE, a cousin of MRSA) had destroyed the disk between T-8 and T-9. Over the 6 months since the fall, I'm still taking anti-biotics but the pain is almost gone. But I'll be left with a bump on my spine where the vertebrae have fused in their misalignment. I believe that X-rays are useless in all but the most gross bone breaks. Next time I think I've broken a bone, I'll insist on an MRI ... and a doctor that isn't so cavalier! A couple of weeks after the fall, I needed 10 Norco per day ... now I'm down to 4 per day ... and, I hope, none in a few more weeks!


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