Osteoporotic vertebral fractures - recent and old

Case contributed by Roberto Schubert
Diagnosis certain


Episode of acute back pain in known osteoporosis. Steroid treatment for COPD.

Patient Data

Age: 70
Gender: Male

Recent fractures of the 8th and 10th thoracic vertebrae with low signal on T1 and high signal on STIR. Deformities of Th12 (fish vertebra) and L1 through L5 (biconcave deformities or endplate impressions) from earlier fractures. Epidural lipomatosis L2-L5.

Case Discussion

Vertebral fracture should be diagnosed when there is loss of height in the anterior, middle, or posterior dimension of the vertebral body that exceeds 20%.

Osteoporotic spine fractures can be graded based on vertebral height loss, as: 

  • mild: 20-25%
  • moderate: 25-40% 
  • or severe: >40%

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