Presentation
Fall 6 weeks ago. L4 superior endplate fracture. Weak legs.
Patient Data
Extensive altered marrow signal throughout the visualized spine and pelvis in keeping with diffuse metastatic disease.
Loss of height T12 and L4, in keeping with superior end-plate fractures. No bone edema to suggest these are acute.
Normal cord and cauda equina.
Extensive para-aortic and common iliac lymphadenopathy measuring up to 5cm.
No hydronephrosis.
Case Discussion
This was the patient's presentation with and resultant diagnosis of metastatic prostate carcinoma.
Always check the periphery of the images for clues. In this case, pathological nodes indicating in this age and gender prostate carcinoma as the likely primary.
His PSA level was subsequently measured and was 2534 ng/ml.
He proceeded to urological care following MDT discussion.