Citation, DOI & article data
The ivory vertebra (also known as ivory vertebra sign) sign refers to the diffuse and homogeneous increase in opacity of a vertebral body that otherwise retains its size and contours and with no change in the opacity and size of adjacent intervertebral discs.
The cause for an ivory vertebra depends on the age of the patient 1.
- lymphoma: commonest cause, usually Hodgkin lymphoma
- blastic metastatic disease
- osteoblastic metastases
- lymphoma (usually Hodgkin lymphoma)
- tuberculous spondylitis
Paget disease of bone
- vertebral body expansion (unlike hemangioma)
- coarsened trabeculae
- SAPHO syndrome 3
Rarely, the ivory vertebra can also be seen in 4:
A helpful mnemonic is LIMPH.
Plain radiograph and CT
Plain radiographs and CT will demonstrate diffuse sclerosis of the vertebral body with variable involvement of the posterior vertebral elements.
MRI demonstrates hypointense signals within the corresponding vertebra which is directly proportional to the degree of sclerosis of the vertebral body.
- 1. Graham TS. The ivory vertebra sign. Radiology. 2005;235 (2): 614-5. doi:10.1148/radiol.2352021743 - Pubmed citation
- 2. Donald Resnick. Diagnosis of Bone and Joint Disorders. 4th Edition (2002)
- 3. Parlier-Cuau C, Laredo J. [Vertebral involvement in SAPHO syndrome]. (2010) Journal de radiologie. 91 (9 Pt 2): 1068-78. Pubmed
- 4. Palmer W, Bancroft L, Bonar F et-al. Glossary of terms for musculoskeletal radiology. (2020) Skeletal Radiology. 49 (1): 1. doi:10.1007/s00256-020-03465-1 - Pubmed