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MSK – Muskuloskelettale Physiotherapie 2025; 29(02): 106-110
DOI: 10.1055/a-2509-2819
Originalarbeit

Anhaltende Schmerzen im thorakolumbalen Übergang, verursacht durch eine osteoporotische Wirbelsäulenfraktur: Ein Fallbericht

Persistent Pain in the Thoracolumbar Junction Caused by an Osteoporotic Spinal Fracture: A Case Report
Wolfgang Lackenbauer
1   IMC Hochschule für Angewandte Wissenschaften Krems, Österreich
,
Simon Gasselich
1   IMC Hochschule für Angewandte Wissenschaften Krems, Österreich
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Zusammenfassung

Eine 68-jährige Patientin wird wegen sich verschlimmernder Rückenschmerzen von ihrem Hausarzt mit der Diagnose „chronisch-rezidivierende Lumbago und ISG-Blockaden“ zur Physiotherapie überwiesen.

Die Patientin berichtet, dass sie seit 2 Monaten unter starken Schmerzen im thorakolumbalen Übergang (TLÜ) leidet, die zeitweise linksseitig über die untersten Rippen seitlich nach vorne in den Unterbauch in Richtung linke Leiste ziehen. Bei der körperlichen Untersuchung fällt eine deutliche Druckdolenz im Bereich des 12. Brustwirbelkörpers (BWK) auf. Da die Patientin zusätzlich die Diagnose „Osteopenie“ erhalten hatte und vor 20 Jahren an Brustkrebs erkrankt war, schickt der behandelnde Therapeut die Patientin zurück zum Hausarzt mit der Bitte um weiterführende diagnostische Abklärung. Ein durchgeführtes Röntgen bestätigt den Verdacht und zeigt eine osteoporotische Wirbelsäulenfraktur des BWK 12. Eine auf Grund der Brustkrebserkrankung zusätzlich durchgeführte Magnetresonanztomografie (MRT) der Wirbelsäule bringt keine weiteren Erkenntnisse.

Abstract

A 68-year-old female patient is referred for physiotherapy by her General Practitioner (GP) due to worsening back pain with the diagnosis “chronic recurrent lumbago and sacroiliac joint blockages”.

The patient reports that she has been suffering from severe pain in the thoracolumbar junction for 2 months, which occasionally extends on the left side over the lowest ribs laterally forward into the lower abdomen towards the left groin. During the physical examination, the area of the 12th thoracic vertebral body is considerably tender on palpation. As the patient has also been diagnosed with osteopenia and had breast cancer 20 years ago, the treating physiotherapist sends the patient back to her GP with a request for further diagnostic clarification. An X-ray confirms the therapist’s suspicions and shows an osteoporotic spinal fracture of the 12th thoracic vertebra. An additional magnetic resonance imaging (MRI) of the spine carried out due to the breast cancer in the patient’s medical history did not provide any further findings.

Schlüsselwörter

Red Flag Screening - schwerwiegende Pathologien - klinischer Entscheidungsprozess - interprofessionelle Zusammenarbeit - Physiotherapie

Keywords

red flag screening - serious pathology - clinical decision-making process - interprofessional collaboration - physiotherapy


Publication History

Received: 19 May 2024

Accepted: 19 June 2024

Article published online:
15 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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