Beta Thalassemia major

Case contributed by Henry Knipe
Diagnosis almost certain


Back pain one-month post motor vehicle collision.

Patient Data

Age: 60 years
Gender: Male

Permeative appearance of the lumbar vertebrae and sacrum with regions of cortical thinning and prominent trabeculations. No focal osseous lesion. Normal vertebral body height. Right L2 transverse process fracture with periosteal reaction.

Presacral soft tissue density mass. Paraspinal tissues demonstrate no gross abnormality. 

Prior right femoral neck internal fixation with a screw and intramedullary nail.

Case Discussion

This patient had a known history of beta Thalassemia major, which accounts for the permeative appearance of the lumbar vertebrae due to increased red marrow and the presacral mass reflects extramedullary hematopoiesis. There is a lumbar transverse process fracture, which accounts for the patient's pain post motor vehicle collision. 

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