“ Non-traumatic collapse commonly affects elderly patients, mostly in the thoracic or lumbar spine and mostly due to osteoporosi s. However,...
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Non-traumatic collapse commonly affects elderly patients, mostly in the thoracic or lumbar spine and mostly due to osteoporosis. However, up to 40% of bone metastases are to the vertebral bodies and may result in pathological fracture. Differentiating benign from malignant collapse is important for directing treatment.
MRI
• Acute fractures are low T1 regardless of cause—the low T1 signal normalises in benign fractures after about 6 weeks, enhancement is non-specific.
• Findings suggesting malignancy:
– Convex posterior bulge of the vertebral body.
– Abnormal signal extends to the pedicles/posterior elements.
– Epidural mass.
– Metastases elsewhere in the spine.
• Findings suggesting osteoporotic fracture:
– Retropulsion of bone fragments.
– Multiple fractures.
– Intervertebral vacuum phenomenon.
– Spared bone has normal signal intensity.
Fracture line band parallel to endplate.
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