1 Generalized Vertebral Osteoporosis

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig SP 1-1 Osteoporosis of aging. Generalized demineralization of the spine in a postmenopausal woman. The cortex appears as a thin line that is relatively dense and prominent (picture-frame pattern).

• Fig SP 1-2 Steroid-induced osteoporosis. Lateral view of the thoracic spine in a patient on high-dose steroid therapy for dermatomyositis demonstrates severe osteoporosis with thinning of cortical margins and biconcave deformities of vertebral bodies.

• Fig SP 1-3 Cushing's syndrome due to adrenal hyperplasia. Marked demineralization and an almost complete loss of trabeculae in the lumbar spine. The vertebral end plates are mildly concave and the intervertebral disk spaces are slightly widened. Note the compression of the superior end plate of L4.1

• Fig SP 1-4 Multiple myeloma. Diffuse myelomatous infiltration causes generalized demineralization of the vertebral bodies and a compression fracture of L2.

• Fig SP 1-5 Sickle cell anemia. (A) Biconcave indentations on both the superior and inferior margins of the soft vertebral bodies produce the characteristic fish vertebrae. (B) Localized step-like central depressions of multiple vertebral end plates.

• Fig SP 1-6 Osteogenesis imperfecta. In addition to generalized osteoporosis, some vertebrae show biconcave deformities, whereas others demonstrate anterior wedging.2

• Fig SP 1-7 Homocystinuria. Scoliosis and osteoporosis.2

• Fig SP 1-8 Idiopathic juvenile osteoporosis. Lateral radiographs of (A) thoracic and (B) lumbar regions of the spine show striking osteoporotic lucency associated with severe compression and collapse of multiple vertebral bodies. Note the ballooning of several disk spaces.2