How to Diagnose and Manage Vertebral Compression Fractures in the ED

The podcast addresses the diagnosis and management of vertebral compression fractures in older adults. It is a conversation between podcast host Dr. Christina Shenvi and Dr. Bob Dachs, who shares his experience in emergency and geriatric medicine. They highlight the high prevalence of these fractures, often resulting from minor trauma due to underlying osteoporosis. The discussion covers risk factors, emphasizing the importance of distinguishing between acute fractures and those caused by malignancy or osteomyelitis. Diagnostic strategies, including the limitations of X-rays and the utility of MRI, are reviewed. Management focuses on pain control, considering acetaminophen, cautious opioid use, and nasal calcitonin. The role of bracing and physical therapy is also explored, alongside secondary prevention strategies like calcium, vitamin D, and bisphosphonates.