A compression fracture is a collapse of a vertebra. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection. In healthy patients, it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an ejection seat. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view. Signs and symptoms
Acute fractures will cause severe back pain. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height. Diagnosis
Compression fractures are usually diagnosed on spinal radiographs, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. In addition, bone density measurement may be performed to evaluate for osteoporosis. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed. Treatment
Conservative treatment
Back brace for support while the bone heals—either a Jewett brace for relatively stable and mild injuries, or a thoracic lumbar sacral orthosis (TLSO) for more severe ones. Opioids or non-steroidal anti-inflammatory drugs (NSAIDs) for pain. For osteoporotic patients, calcitonin may be helpful.
Other autoimmune diseases, such as systemic lupus erythematosus, can also cause myositis-like symptoms. Diagnosis
There are various tools that can be used to help diagnose myositis. The most common ones are: physical exam, electromyography, magnetic resonance imaging, muscle biopsy, and blood tests. The first thing your doctor will likely do is perform a physical exam. They will look for various things such as muscle weakness and rashes. Another possible test is an electromyography (EMG). This is a test that inserts tiny needles into your muscles. This allows a physician to look at your muscles’ response to various electrical nerve signals and evaluate which muscles potentially have myositis. Magnetic resonance imaging (MRI) is also useful. This is a test that uses a big magnet to create images on a computer. This allows a physician to examine your muscles. It is painless. Muscle biopsies are the most reliable tests for diagnosing myositis. It will tell your doctor for certain if you have myositis or not. There are also a variety of blood tests available that help in the diagnoses of myositis. Your doctor may look for elevation of creatine kinase in blood, which is indicative of muscle inflammation. Certain autoantibodies (antibodies that target your muscle cells) can also be found in the blood that can indicate that myositis is caused by an autoimmune disease. Some specific examples of autoantibodies are Anti-Jo-1, Anti-HMGCR, Anti-TIF1, etc. Treatment
Treatment for myositis depends on the underlying cause. For myositis that is caused by a viral infection, no treatment is typically needed.