Mid-back pain

A 65-year-old man who has been experiencing mid-back pain for a month seeks medical attention. He thinks the pain began due to a fall from standing height on the driveway. He was experiencing slight back pain now, but he could still easily escape the situation. Over the past month, the back pain has been mild and progressively worse. He finds that lifting, squatting, and bending worsen his back pain. A thoracic compression fracture at T11 is visible on radiographs (Figure 1). Oedema in the T11 vertebral body is shown on sagittal magnetic resonance imaging (MRI) (Figure 2), which is consistent with an acute compression fracture. Dual-energy X-ray absorptiometry (DEXA) scans of the patient revealed that his hip and lumbar spine have normal bone density.