Low back pain following a fall.

Abstract

The patient was a 29-year-old man who presented to an emergency department with a chief complaint of low back pain. Symptom onset occurred 3 weeks earlier, following a fall off a roof. The physician ordered radiographs of the thoracic and lumbar spines, which were interpreted as normal. After receiving the results of the radiographs, the physician referred the patient to a physical therapist working in the emergency department. Because of the strong suspicion for a fracture and because radiographs are not considered to be sensitive to some of the bony changes associated with fractures,1 computed tomography imaging of the thoracic and lumbar spines was ordered. The computed tomography imaging revealed multilevel, small end-plate compression defects, most marked at T12-L1, with mild anterior wedging and retropulsion of a small bone fragment at L1.