Ivory vertebra sign

Case contributed by Dr Safwat Mohammad Almoghazy

Presentation

A known case of stage IV prostate cancer with multiple bony metastases.

Patient Data

Age: 65 years
Gender: Male
X-ray

Uniformly increased opacification of the entire L2 vertebra. The vertebral body maintains its normal size and contour.

Note slightly sclerotic focal opacity of the anteroinferior aspect of the L1 vertebra.

Multiple surgical clips are seen in the pelvis denoting the previous operation.

Case Discussion

This finding represents the typical ivory vertebra sign due to osteoblastic bone metastasis (in this patient known prostate cancer).

Although most commonly due to a sclerotic bony metastasis, these appearances can also occur in lymphoma and Paget disease of the bone.

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