Acute and chronic vertebral compression fractures

Case contributed by Dr Andrew Dixon

Presentation

Car accident. Thoracic spine pain.

Patient Data

Age: 75
Gender: Male

Thoracic Spine CT

Modality: CT

13 paired ribs. First rib bearing vertebra is taken as T1. Buckling of the superior portion of the T6 and T10 vertebral bodies consistent with acute fractures. Note the angulation of the anterior and lateral cortex at these two levels and subtle compressive sclerosis in the medullary cavity where the normal trabeculae have been impacted. Old vertebral body compression fractures at T9 and L1. Note the remodelled cortex and endplate at these levels without any sharp buckling of the cortex.    

Modality: Annotated image

White arrows indicate acute vertebral body compression fractures. Yellow arrows indicate chronic vertebral body compression fractures. 

Case Discussion

This case demonstrates the differences between acute and chronic vertebral body compression fractures on CT, emphasising the cortical buckling and subtle trabecular impaction seen with acute fractures compared to the well-defined remodelled appearance of old fractures. 

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Case Information

rID: 31608
Case created: 18th Oct 2014
Last edited: 24th Nov 2015
System: Spine
Inclusion in quiz mode: Included

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