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.

Bone scan

Nuclear medicine

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

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