Case contributed by Dr Sinéad Culleton


A 35 year old lady presented with back pain and knee pain following a fall.

Patient Data

Age: 35
Gender: Female

X-rays of the cervical, thoracic and lumbar spine show densely sclerotic endplates, alternating in bands and illustrates the sandwich vertebral body sign of osteopetrosis. No fracture was identified.


There is diffuse increased density and sclerosis of the visualised bones consistent with osteopetrosis



Case Discussion

In osteopetrosis the vertebral bodies have a 'sandwich' appearance., due horizontal well demarcated sclerosis abutting the endplates with central intervening portion is less dense hence the 'sandwich' appearance.

This is often used interchangeably with 'rugger' jersey spine. However this is typically associated with renal osteodystrophy. The 'sandwich' appearance of osteopetrosis has sharp very well demarcated areas of sclerosis and in 'rugger jersey' the margin between sclerotic and less dense bone is not as sharp, often in addition there are other imaging findings suggestive of renal osteodystrophy.

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Case information

rID: 40497
Case created: 23rd Oct 2015
Last edited: 12th May 2017
Inclusion in quiz mode: Excluded

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