Osteoporotic compression fracture
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Synopsis
An osteoporotic compression fracture is a nontraumatic fracture, usually of the vertebrae, caused primarily by loss of bone density. Compression fractures present with acute, localized spine pain that infrequently radiates to the ribs. Pain worsens with movement and palpation. However, many compression fractures are asymptomatic or may present with height loss.Risk factors for compression fractures include advanced age, female sex, low body weight, chronic corticosteroid use, previous fractures, malabsorptive disorders, and abnormalities of testosterone or estrogen. Osteoporotic compression fractures are less commonly secondary to diseases such as hyperparathyroidism, connective tissue disorders, or malignancy.
Although generally not life threatening, compression fractures of the spine may cause functional impairment. Patients may have difficulty with bending over, walking, lifting objects, or activities of daily living.
Treatment of stable, symptomatic fractures is usually conservative, with bracing and pain control emphasized. Pain often resolves within 6 weeks of conservative management. Surgical interventions such as vertebroplasty or spinal fusion are sometimes used, particularly for treatment-refractory pain or symptoms of spinal cord / root compression. Osteoporosis should also be medically addressed.
Codes
ICD10CM:M80.80XA – Other osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture
SNOMEDCT:
443395009 – Compression fracture
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Although most cases of compression fracture are due to osteoporosis, it is important to consider other causes of compression fracture. Alternative diagnoses should be considered if the presentation does not fit the typical risk factors associated with osteoporosis (eg, young patient, male patient, fracture above the T4 level or in the cervical spine). The differential includes:- Osteomalacia
- Hyperparathyroidism
- Sarcoidosis
- Tuberculosis (Pott disease)
- Trauma
- Malignancy
- Scheuermann disease (juvenile kyphosis)
- Paget disease
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:04/15/2019
Last Updated:09/30/2019
Last Updated:09/30/2019
Osteoporotic compression fracture