Presentation
Back pain.
Patient Data
Diffuse heterogeneous marrow T1 hyperintense signal, no abnormal focal lesion, suggesting osteoporosis/multiple focal fatty marrow sites (in line with DEXA scan finding).
Loss of L5 vertebral body height with band-like low T1 signal/fracture line at the superior endplate anterior, and middle column (involving the posterior vertebral wall), wedging of the anterior aspect of the inferior end plate with diffuse vertebral body edema-like signal intensity. Hyperintense T2/STIR signal was seen at the endplate-disc complex above and below the L5 level representing intradiscal edema/hemorrhage.
Buckling of the superior aspect of L5 posterior wall/retro-pulsed fragment causing focal posterior convexity indenting the thecal sac and together with hypertrophied ligamentum flavum causing focal moderate spinal canal stenosis, no pedicle involvement (expansile or deposit-like abnormality), no focal paraspinal/ epidural mass.
Case Discussion
L5 vertebral body incomplete burst fracture of the superior end plate (severe, >40% height loss) indicating an acute L5 osteoporotic compression fracture, no morphologic features of malignant compression fracture.
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