Learning objectives
Atraumatic vertebral compression fractures in the thoracic or lumbar spine are a common clinical problem,
particularly in elderly patients.
It is important the differentiation of compression fractures caused by metastatic malignancy from those caused by osteoporosis,
both frequent in this age group.
This poster objectives are to demonstrate the accuracy of different imaging methods and illustrate themain imaging findings of pathological and insufficiency fractures,
exhibiting factors that differentiate the two entities,
especially in magnetic resonance imaging (MRI).
Background
Atraumatic or traumatic vertebral compression fractures are common clinical problems,
especially in the elderly population,
and represents a challenge that confronts clinicians and radiologists once these patients are more predisposed to osteoporosis and also have a higher incidence of neoplastic lesions.
Osteoporosis is the most common cause of vertebral fracture in the elderly,
but nearly half of bone metastases compromise the spine and it is not so infrequent that a metastatic pathological fracture presents as the first manifestation of a neoplasm.
The distinction between these...
Findings and procedure details
We evaluated a great number of fractures cases,
correlating them with anamnestic data about preexisting disease and clinical evolution,
and have observed differences between the biomechanics of vertebral atraumatic fractures.
We also notice that these differences can be demonstrated by imaging methods,
with distinct grades of accuracy,
even though all conditions lead to destruction of the vertebral bodies.
As described in the literature,
in pathological neoplastic fractures the trabecular bone is replaced by tumor cells with partial destruction of the vertebral body.
The timing of...
Conclusion
In suspicion of a vertebral fracture,
the radiologist’s most important goal is to differentiate between benign and malignant causes,
due to the influence in the treatment and prognosis of the patient.
Although osteoporosis is a preventable and treatable disease,
the patient has a greater tendency for other fractures.
In case of metastasis,
the increase of the lesion may lead to spinal compression and irreversible neurological symptoms.
MRI is the best method for this distinction and the combination of morphological changes and intensity of signal increases...
Personal information
Dr.
Marcelo Ricardo Canuto Natal
Neuroradiology Section.
Department of Radiology,
Instituto Hospital de Base do Distrito Federal.
SMHS – Área Especial – Quadra 101 - Asa Sul,
Brasília - DF,
70330-150.
Head of Imaging Department of Sabin Medicina Diagnóstica.
SCN 01 – Quadra 01 – Bloco D – Asa Norte,
Brasília – DF,
70711-040.
E-mail:
[email protected]
Dra.
Thaís Figueiredo Teodoro de Oliveira
Resident in training.
Department of Radiology,
Instituto Hospital de Base do Distrito Federal.
SMHS – Área Especial – Quadra 101 - Asa Sul,...
References
1.Natal MRC,
Teixeira AA,
Santos GV.
Alterações traumáticas da coluna vertebral.
In: Silva CIS,
D’Ippolito G,
Rocha AJ,
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1st ed.
Rio de Janeiro: Elservier; 2014 P.
467-516.
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Shah LM,
Hanrahan CJ.
MRI of spinal bone marrow: part 2,
T1-weighted imaging-based differential diagnosis.
Am J Roentgenol.
2011;197(6):1309-21.
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Jung HS,
Jee...