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Vertebral compression fracture

Case contributed by Dr Sally Ayesa

Presentation

Atraumatic back pain. Otherwise well.

Patient Data

Age: 70 years
Gender: Female
Nuclear medicine

Three phase bone scan

On the early phase blood pool image, there is minor focal hyperemia in the right lower thoracic spine, seen best on the posterior image. 

On planar delayed phase imaging, there is focally increased tracer accumulation in the lateral aspects of the T11 vertebral body. There is also incidental intense periarticular uptake in the medial compartments of both knees (right greater than left). 

On SPECT/CT, there is linear uptake corresponding to the superior endplate of the T11 vertebral body, with mild endplate depression and sclerosis on low dose CT. 

Case Discussion

On bone scan, acute or subacute endplate compression fractures demonstrate linear uptake on delayed phase imaging. There is variable hyperemia on early phase imaging, depending on the age of the fracture. Uptake does not cross the intervertebral junction as it would be expected to in a case of discitis. 

SPECT/CT is useful to confirm the location of the uptake within the vertebral body.

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Case information

rID: 80154
Published: 17th Jul 2020
Last edited: 19th Jul 2020
System: Spine
Inclusion in quiz mode: Included
Institution: Royal North Shore Hospital

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