Analysis of Misdiagnosis of Atypical Osteoporotic Vertebral Compression Fracture in the Middle-aged and Elderly
LI Zhiqiang
JIN He
LI Chungen
ZENG Jun
Abstract：Objective To analyze the clinical features and imaging manifestations of atypical osteoporotic vertebral compression fractures(OVCF)in the middle-aged and elderly patients,and to summarize the causes of misdiagnosis and pre-ventive measures.Methods The clinical data of 11 middle-aged and elderly patients with OVCF who had been misdiagnosed in the early stage from March 2019 to May 2021 were retrospectively analyzed.Results The main complaint of 11 cases in-cluded hypochondriac pain in 5 cases,digestive system symptoms such as belching,loss of appetite,abdominal pain and ab-dominal distension in 2 cases,and low back pain in 4 cases.There was no obvious history of trauma.Four patients underwent X-ray examination and 2 patients underwent gastroscopy.There was misdiagnosis as intercostal neuralgia in 5 cases,spinal de-generation in 4 cases,and chronic gastritis in 2 cases.After admission,the patient was diagnosed with OVCF in the middle-aged and elderly according to the results of MRI examination of thoracolumbar spine and positive percussion pain in the spinous process of the injured vertebra.The misdiagnosis lasted 12-20 d.After diagnosis,posterior percutaneous thoracolumbar ky-phoplasty was performed,and postoperative recovery was good.Conclusion The early symptoms of some middle-aged and elderly patients with OVCF are not typical,there is no obvious history of trauma,and the negative rate of early X-ray examina-tion is high;therefore,OVCF is more likely to be misdiagnosed.For middle-aged and elderly(＞50 years old)patients with chest,lumbar and back pain or parochial hypochondriac pain as the main symptom,detailed medical history and physical ex-amination should be conducted to understand the characteristics and causes of pain,and vertebral MRI examination should be performed as soon as possible to prevent misdiagnosis.
Keywords：FracturescompressionOsteoporotic fracturesMiddle-aged and elderlyMisdiagnosisIntercostal neuralgiaChronic gastritisSpinal degenerative diseaseMagnetic resonance imaging
Publication Date：2023-08-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 18-21 )