LAST CHANCE: X-ray Interpretation: Elbow Injuries - Half price course offer ends this Sunday!

Absent pedicle sign (breast cancer metastases)

Case contributed by RMH Core Conditions


Back pain.

Patient Data

Age: 55 years
Gender: Female

Left L2 vertebral lesion is seen, with destruction of the left pedicle. Mild-to-moderate right scoliosis again noted together with degenerative change. Contrast within large bowel.

Nuclear medicine

Bone scan

There are foci of intensely increased radiotracer uptake in T9, L2 and L4. 

Case Discussion

Patient has a known history of breast cancer and this represents osseous metastases. 

Absent pedicle sign refers to the destruction of one pedicle, it is said to give the frontal view of the vertebral body the appearance of a winking owl, hence its alternative name, the winking owl sign

PlayAdd to Share

Case information

rID: 29822
Published: 26th Jun 2014
Last edited: 19th Sep 2020
Tag: spine
Inclusion in quiz mode: Included

Updating… Please wait.

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

 Thank you for updating your details.