Presentation
Weakness of the lower limbs in a pregnant patient (35 weeks).
Patient Data
The MRI sequences demonstrate a collapsed T8 vertebral body which exhibits an intermediate signal on T1WI, high signal on T2WI with multiloculated expansile cystic components of epidural and paravertebral location (mainly on the right) with involvement of the posterior vertebral elements . The cystic areas are composed of cavities of low signal on T1WI, high signal on T2WI with fluid-fluid levels (blood products). The adjacent spinal cord is compressed and displaced anteriorly with an area of high signal on T2WI/STIR.
Case Discussion
MRI features are most consistent of a vertebral aneurysmal bone cyst (ABC) with compressive myopathy.
On imaging the differential diagnosis of bone lesions with intrinsic fluid-fluid levels: see fluid-fluid level containing bone lesions.