A 60-year-old woman presents with severe back pain that started suddenly. She has a history of osteoporosis. The pain is localized in the mid-back and is not related to movement. On examination, there is point tenderness over a thoracic vertebra. What are potential causes and next steps?
Given this patient's age, history of osteoporosis, and the sudden onset of pain, a vertebral compression fracture is a strong possibility. These fractures can occur in people with osteoporosis even without significant trauma. The next step should be imaging, likely starting with an X-ray and potentially followed by a CT or MRI if necessary, to confirm the diagnosis and assess the severity of the fracture.