Kummel disease is an eponymous name for avascular necrosis of the vertebrae.
Kummel disease represents delayed (usually two weeks) vertebral body collapse due to ischaemia and non-union of the anterior vertebral body wedge fractures after major trauma.
Risk factors include:
- corticosteroid use
- radiation therapy
- shows collapse of affected vertebrae
- an intravertebral vacuum cleft and fluid may be seen (accentuated on extension stress lateral views), although this is non-specifc
- the intravertebral vacuum cleft is usually seen as low signal intensity with all sequences
- if intravertebral fluid is present it is low T1 signal on and high T2 signal
The severity of the vertebral collapse has been found to be higher in those who have intravertebral gas compared to only intravertebral fluid, signifying that the presence intra-vertebral air is possibly a more advance stage of the disease 1.
History and etymology
This condition was first described by Herman Kummell in 1891 4.
- 1. Yu CW, Hsu CY, Shih TT et-al. Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels. AJNR Am J Neuroradiol. 2007;28 (1): 42-7. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 2. Baur A, Stäbler A, Arbogast S et-al. Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology. 2002;225 (3): 730-5. doi:10.1148/radiol.2253011413 - Pubmed citation
- 3. Freedman BA, Heller JG. Kummel disease: a not-so-rare complication of osteoporotic vertebral compression fractures. 22 (1): 75-8. doi:10.3122/jabfm.2009.01.080100 - Pubmed citation
- 4. Brower AC, Downey EF. Kümmell disease: report of a case with serial radiographs. Radiology. 1981;141 (2): 363-4. Radiology (citation) - Pubmed citation
- 5. Mirovsky Y, Anekstein Y, Shalmon E et-al. Vacuum clefts of the vertebral bodies. AJNR Am J Neuroradiol. 2005;26 (7): 1634-40. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 6. Theodorou DJ. The intravertebral vacuum cleft sign. Radiology. 2001;221 (3): 787-8. doi:10.1148/radiol.2213991129 - Pubmed citation
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