Type:
Educational Exhibit
Keywords:
Metastases, Osteoporosis, Education and training, Diagnostic procedure, Conventional radiography, CT, MR, Bones, Musculoskeletal spine, Neuroradiology spine
Authors:
T. Oliveira1, R. O. Martins2, M. C. Calegari2, F. Melo1, M. Natal1; 1Brasilia/BR, 2Brasília, DF/BR
DOI:
10.26044/ecr2019/C-1727
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 entities is not always easy,
especially in the acute and subacute stages,
but the differentiation is necessary to establish appropriate therapeutic planning and influences in patient’s prognosis.
This could be achieved by using a combination of imaging techniques,
such as plain radiography,
bone and soft tissue scintigraphy,
computed tomography (CT) and MRI.
Anamnestic data about preexisting disease (old patient with chronic compression fractures,
young patient with known history of carcinoma,
long-term steroids therapy or chemotherapy and history of local irradiation) and clinical data regarding the onset of symptoms (back pain,
presence or absence of myelopathy and gradual or progressive neurological damage) could be very useful to indicate the potential cause of vertebral collapses.