NBME Step 2 CK Form 7 Compression fracture (NBME Answers)

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submitted by step_prep4(11)

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Young girl with a history of chronic corticosteroid use and cushingoid appearance who presents with constant back pain with vertebral point tenderness with imaging showing vertebrae with increased lucency, most consistent with a compression fracture in the setting of steroid-induced osteoporosis
Key idea: Vertebral compression fracture comes in 2 flavors (1) Chronic fracture: Painless with progressive kyphosis and loss of stature (2) Acute fracture: Low back pain with decreased spinal mobility + tenderness at affected level
Key idea: Causes of point tenderness over vertebral body includes compression vertebral fractures, osteomyelitis and metastatic disease to vertebral bone
Risk factors for osteoporosis –> compression fracture: Low weight (osteoporosis), increased age, women, chronic corticosteroid use or Cushing syndrome

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