Flattened Vertebral Body, Multiple



Flattened Vertebral Body, Multiple


Julia Crim, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Traumatic Fractures


  • Pathologic Vertebral Fracture



    • Osteoporosis


    • Metastases, Lytic Osseous


    • Multiple Myeloma


    • Metastases, Blastic Osseous


    • Leukemia


    • Lymphoma


  • Sickle Cell


  • Scheuermann Kyphosis


Less Common



  • Osteogenesis Imperfecta


  • Achondroplasia


  • Cushing Disease


  • Spondyloepiphyseal Dysplasia


  • Caudal Regression Syndrome


Rare but Important



  • Radiation Therapy to Spine in Childhood


ESSENTIAL INFORMATION


Helpful Clues for Common Diagnoses



  • Traumatic spine fractures often occur at multiple contiguous or noncontiguous levels even in young patients


  • MR useful to look for marrow replacement disorder in patients with multiple fractures


  • Metastases



    • Radiographs: Cortical breakthrough, loss of pedicle


    • CT: Destruction of trabeculae


    • MR: Rounded lesions underlying fractures, often elsewhere in spine as well


  • Myeloma, lymphoma, leukemia



    • Similar to metastases, but loss of pedicle uncommonly seen on radiographs


    • MR, CT show posterior element involvement is common


    • Lytic lesions in spine often difficult to see on radiographs



      • Most common appearance is diffuse osteopenia, fractures


    • Focal, round areas of marrow replacement or diffuse marrow replacement may be seen


  • Sickle cell: Vertebral height lost centrally only (“Lincoln Log vertebrae”)


  • Scheuermann kyphosis



    • 5° wedging of at least 4 contiguous vertebrae


    • Schmorl nodes & undulating vertebral endplates


    • Usually involves thoracic spine


Helpful Clues for Less Common Diagnoses

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Flattened Vertebral Body, Multiple

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