Slip and Fall Off Ladder… What is the DDX?

20470

History:

A 60yr old male patient enters the office with complaint of severe low back pain in the L1-3 region bilateral.  He states he was on his ladder at home painting a wall on the exterior of his house when he slipped off and landed on his back.

He states being unable to move for a period 10 minutes before he was able to pull himself off the ground.  Pain is sharp, stabbing and unrelenting.  You send him for an xray and this comes back.

 

fdd929c2d1766866fb9cc186d2afc2_big_gallery

Case Discussion:

L1 vertebral burst type fracture and T12 horizontally oriented spinous process fracture.

Two column fracture of the L1 vertebral body involving superior end-plate compression and mild retropulsion of the posterior vertebral body margin. Associated horizontally oriented fracture of the T12 spinous process without obvious widening of the interspinous distance at T12-L1 to suggest posterior ligamentous disruption.

 

Did you diagnose correctly?   Whats your action plan from here?

 

Case courtesy of Dr Andrew Dixon, Radiopaedia.org. From the case Lumbar spine fractrue

Comments

comments