Vertebral metastases - absent pedicle

Case contributed by Frank Gaillard

Presentation

Mid thoracic back pain.

Absent left pedicle of T11 vertebra.

Lytic lesion at left pedicle of T11 vertebra.

Case Discussion

X-rays of the thoracic spine demonstrate the left  T11 pedicle to be absent, seen only on AP projection and is called the winking owl sign. This is confirmed on CT, with evidence of other lytic spinal metastases

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