![]() The thoracic and lumbosacral spine are the usual sites of disease. Langerhans’ cell histiocytosis * – the spine is more frequently involved in eosinophilic granuloma and Hand–Schüller–Christian disease than in Letterer–Siwe disease. Infection – destruction of end-plates adjacent to a destroyed disc.Ħ. Scheuermann’s disease – irregular end-plates and numerous Schmorl’s nodes in the thoracic spine of children and young adults. MRI usually shows the end-plates to be spared, cf. The lower cervical, lower dorsal and upper lumbar spine are most commonly affected. Trauma – discontinuity of trabeculae, sclerosis of the fracture line due to compressed and overlapped trabeculae. Paravertebral soft-tissue mass is more common in myeloma than metastases.ģ. Disc spaces are usually preserved until late. Altered or obliterated normal trabeculae. ![]() multiple myeloma, leukaemia and lymphoma. Neoplastic disease – wedge fractures are particularly related to osteolytic metastases and osteolytic marrow tumours, e.g. If other non-collapsed vertebrae are affected then diagnosis becomes much easier.Ģ. Paget’s disease * – diagnosis is difficult when a solitary vertebra is involved. Benign tumours – haemangioma, giant cell tumour and aneurysmal bone cyst.ħ. The posterior elements are usually spared.Ħ. Langerhans’ cell histiocytosis * – eosinophil granuloma is the most frequent cause of a solitary vertebra plana in childhood. Infection – with destruction of vertebral end-plates and adjacent disc spaces.ĥ. Coarsened trabecular pattern in adjacent vertebrae due to resorption of secondary trabeculae.Ĥ. Osteoporosis (q.v.) – generalized osteopenia. ![]() May mimic an osteolytic metastasis or be expansile and resemble an aneurysmal bone cyst.Ģ. (b) Multiple myeloma/plasmacytoma* – a common site, especially for plasmacytoma. The bone may be lytic, sclerotic or mixed. The disc spaces are preserved until late. (a) Metastasis – breast, bronchus, prostate, kidney and thyroid account for the majority of patients with a solitary spinal metastasis. ![]()
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