Silent compression fractures

[Judythg]

I listened to a video by Sara Meeks where she stated that silent compression fractures account for 70% of such types of fractures. She explained that the pain from compression fractures may not be obvious or may occur as pain in the ribs or front of the body. Given this information, I believe I have had 3 compression fractures over the years but did nothing about it - doctors I went to xrayed my ribs and found nothing. My question - is there any benefit at this time to determining whether I did, indeed, suffer compression fractures?

[karmel]

I understand that the only way that you know if you have had a silent compression fracture is to have an MRI scan, as not all fracture show up on a DEXA scan or on an an x-ray. Everytime my back feels strained or aches I wonder if I have got a silent compression fracture

[uncountable3 in reply to karmel]

I thought spinal compression fractures healed but never rebounded. Why would the distortion from a "silent" compression fracture not show up on an x-ray?

[Judythg in reply to uncountable3]

I think it would still show up, but the question is whether there is any benefit to confirming my suspicions. I am already under treatment for osteoporosis, so I am not sure what confirming the fractures would do. I do know that every time I went to the endocrinologist initially they asked me if I had any fractures and I responded that I had not, and they still recommended the treatment that they did based on my Dexa scores.

[karmel in reply to uncountable3]

When I had my last DEXA I could not understand the improvement in my spine score and I was told by ROS (that is the royal op society in the UK) that it could mean that I had arthritis in my back or a fracture and if it was a fracture it would show up on the DEXA report, which is did not and I would have thought that if I had arthritis in my back I would have known. I was very confused about the conflicting reasons I was given by my doctor and I read about others who had had silent compression fracture that did not always show up on x-rays but did on an MRI scan. I chose to have another different type of bone scan, I think it is called Echolight in the States,

[uncountable3 in reply to karmel]

Speculation here but I think what is happening is that small compression fractures are more difficult to see on an X-ray. My original suspicious fracture was a T12 compression fracture from a traumatic event. It wasn't until the second follow-up X-ray that a smaller fracture on T8 was noticed. The radiologist and the neurosurgeon also disagreed on whether there was a fracture to the coccyx.

[Judythg]

My understanding from watching a couple of Sara Meeks videos is that the DEXA does NOT scan the entire spin - only the lower spine. And most compression fractures occur up higher.

[uncountable3 in reply to Judythg]

That's pretty much true. DXA focuses on the hips, lumbar spine, and sometimes the forearm but spinal compression fractures are most common in the thoracic spine. I don't know any reason why they couldn't do the thoracic spine but they don't. Also, DXA isn't intended to find fractures. Fractures actually mess up the result. On my last scan, they scanned my forearm. Usually, they scan the non-dominant forearm but I had a two-year-old fracture on my non-dominant forearm so they scanned the dominant forearm.

[Judythg in reply to uncountable3]

But can you think of any good reason why I need to confirm whether or not I had 3 compression fractures, latest of which was probably 7 years ago? I am already under treatment for osteoporosis - it would just be another data point I guess.

[FearFracture in reply to uncountable3]

DEXAs don’t work on the thoracic spine. They scan L1-L4 because there are no other bones in the way. Your ribs would skew the results if they were to scan the thoracic spine.

[mollysuki]

I’m guessing here but having it confirmed may mean a different course of treatment. When I had a X-ray it revealed the fracture but then had an MRI which showed several old compression fractures.

[Judythg in reply to mollysuki]

And what was the result of finding your old fractures? Did your course of treatment change or did the health professional say or do anything in particular after discovering the old fractures?I'm trying to figure out whether it is worth pursuing getting an MRI to find what I suspect are my old fractures.

[bellybuddie in reply to Judythg]

I have exact question as yours! My endo would ask me every time we met if I had any recent fracture. Now I'm suspecting my discomfort of one chest region might be compression fracture, she dismissed it and direct me to ask my pcp to investigate my discomfort.

Did you end up having anything tests done to figure out? I'm thinking having a confirmed fracture might alter frax score, which predict one's future probability of fracture. Bad frax score may also influence selection of meds.