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Vertebral fracture — DGM MCQ

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ModerateFallsVertebral fractureDGM

An 80-year-old man develops acute mid-thoracic pain after lifting a shopping bag. He has lost 4 cm height over two years and uses oral prednisolone for polymyalgia. Examination shows focal spinal tenderness without neurological deficit. Current medicines include prednisolone and omeprazole. What is the most likely diagnosis?

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Correct answer: A — Osteoporotic vertebral compression fracture

Acute focal thoracic pain after minimal strain with height loss and steroid exposure suggests vertebral compression fracture. Renal colic gives flank pain, cervical myelopathy causes upper motor neurone signs, hip osteoarthritis causes groin pain, and BPPV causes vertigo. Steroid exposure is a major fracture-risk factor and should prompt bone protection review.

Reference: NICE CG146