Vertebral metastasis - draped curtain sign
Back pain, weight loss and lower limb weakness.
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Other investigations identified a renal cell carcinoma.
The bilobed appearance can be explained by the strong attachment of the posterior longitudinal ligament (PLL) to the back of the vertebral body in the midline. The lesion expands into the epidural space on either side of this attachment. This has been called the "draped curtain" sign.