Vertebral hemangioma

Case contributed by Bahman Rasuli
Diagnosis certain


Lower back pain after trauma.

Patient Data

Age: 30 years
Gender: Male

The T1 and T2-weighted images show a lesion of increased signal intensity replacing the entire L3 vertebral body. Coarse vertically oriented trabeculae are present.

Case Discussion

The recent case referred to our center with the history of lower back pain after trauma for seeking disc herniations and the hemangioma was an incidental finding.

Vertebral hemangiomas are the most common benign vertebral neoplasms. They are usually asymptomatic and incidentally detected due to their characteristic features on imaging for other reasons. Rarely, they can be locally aggressive, though the diagnosis can be challenging. In such cases, the recognition of vertically oriented coarse bony trabeculae surrounded by fatty stroma, resulting in a “salt and pepper” appearance or "polka dot sign" on axial images and a striated appearance on coronal or sagittal images, is the key to help the correct diagnosis. 

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