A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.”
Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, though there is mild discomfort with deep palpation in the right low back musculature. The patient denies any pain with motion of the torso. There is no rash or evidence of zoster.
View the image taken (Figure 1) and consider what your diagnosis would be. Resolutions of the case is described on the next page.