Osteoporotic vertebral fractures with no sign of vertebral collapse on initial radiographs do indeed exist. They are analogous to occult stress fractures well known in other skeletal sites. They must not be misdiagnosed as malignant lesions.

The backflow technique allows to accurate the intra-articular placement of the needle for "dry" knee joints injection. This technique can be proposed as a learning tool as well as a daily practice technique to ascertaining intra-articular knee injections without using fluoroscopy with injection of contrast material. Further studies are needed to assess the technique for other joint injections.

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Pamidronate provides rapid and sustained pain relief in patients with acute painful osteoporotic VCF and is well tolerated. Further investigations are needed to better define the place of pamidronate in the management of painful recent osteoporotic collapse.

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