Kümmell disease

Case contributed by Dr Dalia Ibrahim

Presentation

Severe back pain. No history of trauma.

Patient Data

Age: 65-year-old
Gender: Female
MRI

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).

CT

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 (vaccum phenomenon)

 

Annotated image

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:

  • osteoporosis
  • 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
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Case information

rID: 31845
Case created: 31st Oct 2014
Last edited: 18th Nov 2017
Inclusion in quiz mode: Included

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