IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Vertebral metastasis - draped curtain sign

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Back pain, weight loss and lower limb weakness.

Patient Data

Gender: Male

Intermediate to high signal expansion of posterior aspect of vertebral body into epidural space, with a bilobed appearance. Effacement of CSF with cord compression.

Findings in keeping with metastatic cord compression. 

Case Discussion

Other investigations identified a renal cell carcinoma.

The bilobed appearance can be explained by the strong attachment of the posterior longitudinal ligament (PLL) to the back of the vertebral body in the midline. The lesion expands into the epidural space on either side of this attachment. This has been called the "draped curtain" sign.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.