Draped curtain sign caused by vertebral metastasis
Back pain, weight loss and lower limb weakness
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Intermediate to high signal expansion of posterior aspect of vertebral body into epidural space, with a bilobed appearance. Effacement of CSF with cord compression.
Findings in keeping with metastatic cord compression.
Other investigations identified a renal cell carcinoma.
The bilobed appearance can be explained by the strong attachment of the posterior longitudinal ligament (PLL) to the back of the vertebral body in the midline. The lesion expands into the epidural space on either side of this attachment. This has been called the "draped curtain" sign.