Learning objectives
To describe the radiological characteristics that differentiate the multiple types of ossifications that can affect the spine,
and to know which of them translate a systemic affectation that goes beyond the bone affectation.
Background
In the spine we can find a great variety of calcifications and ossifications affecting the vertebral bodies,
intervertebral spaces and adjacent soft tissues.
From variants of normality to metabolic pathology,
rheumatic diseases or degenerative changes,
knowledge of the different types of spinal ossifications is essential to decrease the differential diagnosis of spinal pathology.
Findings and procedure details
The affectation of the vertebral bodies (alteration in their morphology,
size or mineralization) is usually due to sistemic diseases.
However,
arthropathies usually alter the disc space and the interapophyseal joints.
Alteration of the vertebral body:
- Paget's disease,
which typically produces an increase in gross size with disordered internal structure due to an alteration between bone production and resorption Fig. 1 . Paget's disease can show the typical appearance of“vertebra in frame”,
where the whole cortex is more dense than the trabecular bone of the...
Conclusion
The spine can be affected by a variety of processes that can produce calcifications and ossifications.
An exhaustive analysis of the lesions presented ina patient's spine can help in the diagnosis of various entities,
as well as in stablishing the existence of systemic involvement in a known pathology,
or in delimiting the differential diagnosis between degenerative or inflammatory disease.
References
1)``Radiología de huesos y articulaciones´´.
Adam Greenspan.
Pages [349-502].
2)``Radiología articular: Artritis en blanco y negro´´.
Anne C.
Brower.
Chapters [7-14].
3)``Diffuse idiopathic skeletal hyperostosis (DISH): where we are now and where to go next´´.Mader R,Verlaan JJ,Eshed I,
et al.
RMD Open.2017 Jun 21;3(1):e000472.
doi: 10.1136/rmdopen-2017-000472.
eCollection 2017.
4)``La columna cervical degenerativa´´ E.
Llopis ,
E.
Bellocha,
J.P.
Leóna et al.
Radiología.
2016;58(S1):13-25