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Case Reports
. 2019 Aug 30;12(8):e229987.
doi: 10.1136/bcr-2019-229987.

Importance of screening in physical therapy: vertebral fracture of thoracolumbar junction in a recreational runner

Filippo Maselli  1   2 , Giacomo Rossettini  1 , Antonello Viceconti  1 , Marco Testa  1
Affiliations
Case Reports

Importance of screening in physical therapy: vertebral fracture of thoracolumbar junction in a recreational runner

Filippo Maselli et al. BMJ Case Rep. .

Abstract

Running is one of the most popular sports worldwide. Studies suggest that 11%-85% of recreational runners have at least one running-related injury (RRI) each year, resulting in a reduction or interruption in training. A high risk for running-related injuries (RRIs) represents an important inconvenience counterbalancing the beneficial effects of running. RRIs primarily affect the joints of the lower limb and lumbar spine. Noteworthy, in some cases, the clinical presentation of signs and symptoms is confusing and may hide serious conditions; thus, clinicians have to pay special attention when potential factors arise, such as the presence of red flags. As reported in this case report, patients can present with low back pain (LBP) as a primary problem, mimicking a red flag such as a fracture of the spine. The aim of this case report was to describe a case of a recreational runner presenting with LBP as the sole symptom of an underlying thoracolumbar fracture.

Keywords: back pain; orthopaedic and trauma surgery; physiotherapy (rehabilitation); physiotherapy (sports medicine).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Radiograph showing a closed compression fracture. Thick yellow arrow indicates a closed fracture of the first lumbar vertebrae without involvement of the spinal cord.
Figure 2
Figure 2
CT images showing a comminuted, burst fracture of the vertebral body of L1. Thick yellow arrow indicates, in axial plane (Left side), fracture of the vertebral body of L1 with displaced fragments of of the anterior vertebral wall and also shown are fractures of the right pedicle and left lamina next to the spinous process. Thick yellow arrow indicates, in sagittal plane (right side), fracture of the vertebral body of L1 with displaced fragments of the right and posterior walls, with loose fragments in the vertebral canal, impinging on the dural sac.
Figure 3
Figure 3
Radiograph, showing open reduction and internal fixation of the L1 vertebral fracture; thick yellow arrow indicates stabilising pedicle bars and screws at T12–L2. Left side: posterior view; right side: sagittal view.
Figure 4
Figure 4
Photographs of the patient in a standing position and performing forward flexion movements.
See this image and copyright information in PMC

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