Presentation
Severe back pain. No history of trauma.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/8852227/eff11192351c98f7f665eccb736492_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/8852295/6a4a8da4053393d11f685bba57627b_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/8852337/ffddd49cf06b2621e0d5217ece591c_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/8852227/eff11192351c98f7f665eccb736492_big_gallery.jpg)
Compression fracture of T10 vertebra with intravertebral gas (which elicits persistent signal void at all pulse sequences) as well as a tiny pocket of intravertebral fluid (which elicits low T1 and high T2 signal).
![](https://prod-images-static.radiopaedia.org/images/8870586/26360245309558946fc2861a5b3699_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/8853044/758e5ae37d60d4effbb0bda54a1d2d_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/8870586/26360245309558946fc2861a5b3699_big_gallery.jpg)
Diffuse osteopenia.
Compression fracture of D10 vertebra with short horizontally oriented intravertebral air cleft.
Dorsolumbar spondylosis with multiple D8/9, D10/11,D12/L1, L1/2,L2/3 intra-discal gas (vacuum phenomenon).
![](https://prod-images-static.radiopaedia.org/images/8870869/0f444ef3f7b8568764b5a9ad8cc3ee_big_gallery.jpeg)
Compression fracture of D10 vertebra with intravertebral vacuum cleft and tiny pocket of fluid.
Diffuse osteopenia at the sagittal CT image.
Case Discussion
Kümmell disease is an eponymous name for avascular necrosis of the vertebrae.
Risk factors include:
corticosteroid use
alcoholism
radiation therapy
Plain film/CT
shows collapse of affected vertebrae
an intravertebral vacuum cleft
MRI
the intravertebral vacuum cleft is usually seen as signal void at all sequences
if intravertebral fluid is present it is low T1 signal on and high T2 signal