Presentation
Acute onset of right sided back pain with tenderness to the thoracic spine
Patient Data
Grade 4 compression fracture of the T12 vertebra. There is evidence of intravertebral cleft sign with fluid intensity within it. Patchy loss of the marrow signal with increased edema on the STIR sequences suggests an acute nature of the fracture.
Case Discussion
On MRI, the intravertebral fracture cleft has been described as a linear discrete focus of marked T2-weighted hyperintensity within a vertebral compression fracture.
The cleft results from vacuum release of gas within cracks in the subchondral bone after a vertebral fracture. This cleft then subsequently fills with fluid resulting in the pathognomic MRI appearance as seen above.
This sign can be seen in osteoporotic vertebral compression fractures (as with this patient) and also in some malignant lesions.
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