Vertebral metastasis - draped curtain sign

Case contributed by Vikas Shah

Presentation

Back pain, weight loss and lower limb weakness.

Patient Data

Gender: Male

Intermediate to high signal expansion of posterior aspect of vertebral body into epidural space, with a bilobed appearance. Effacement of CSF with cord compression.

Findings in keeping with metastatic cord compression

Case Discussion

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.

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