Presentation
Lumbar spine tenderness. X-ray lumbar spine shows L2 vertebral collapse ? osteoporotic fracture ? otherwise.
Patient Data
Apparent osteoporosis of the visualized bone.
L2 vertebral body shows bone marrow edema, a wedge-shaped cleft of fluid-like signal and moderate compression fracture, involving the anterior and middle columns with buckling of the posterior wall of the vertebral body resulting in mild focal central spinal canal stenosis at that level. No paravertebral soft tissue edema or swelling. The changes are likely to represent recent compression fracture with focal osteonecrosis, very less likely to represent a malignant process.
Bilateral sacral insufficiency fracture more on the right side. Focal angulation is seen at S2/L3 level. Multilevel mild lumbosacral degenerative changes with disc desiccation more at L4/L5 and L5/S1 levels.
5 cm left adnexal cyst, please correlate with CA125 and transvaginal ultrasound.
Opinion:
L2 vertebral body moderate compression fracture with fluid cleft sign suggestive of recent osteoporotic fracture with possible focal osteonecrosis.
Bilateral sacral insufficiency fracture.
Case Discussion
This case shows the typical appearance of an osteoporotic fracture with prominent fluid-filled cleft (fluid sign in acute vertebral collapse).
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