Flattened Vertebral Body, Solitary

Julia Crim, MD

DIFFERENTIAL DIAGNOSIS

Common

Less Common

ESSENTIAL INFORMATION

Key Differential Diagnosis Issues

Helpful Clues for Common Diagnoses

Radiographic findings suggesting that a vertebra plana is due to tumor
- Normal bone density in remainder of spine
- Cortical destruction: Vertebral body or neural arch
- “Absent pedicle” sign
- Lytic or blastic lesion seen in other vertebrae
MR appearance often allows differentiation between vertebra plana due to osteoporosis and tumor
- Osteoporosis: Band-like or stellate abnormal signal, focal cortical break but no widespread cortical destruction
- Tumor: Cortical destruction, round or ovoid marrow replacement, marrow replacing entire vertebral body or involving neural arch
Langerhans cell histiocytosis most likely cause in young patients
Congenital vertebral anomalies cause well-demarcated hypoplasia

Helpful Clues for Less Common Diagnoses

Other Essential Information

Paraspinous soft tissue mass not a helpful differential diagnostic finding
- May be due to hematoma in nonpathologic fracture, to paraspinous tumor, or to paraspinous abscess

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