MRI Spine Pathological Fractures
In this post we look at the MRI findings that suggest a Pathological Fracture.
| FINDINGS THAT SUGGEST A PATHOLOGICAL FRACTURE |
 Image Above: L1 compression fracture. Benign or malignant. See MRI images below on how to differentiate.
WHAT TO LOOK FOR ON MRI
Image Above: Pathological Fracture demonstrating a convex posterior margin ( pink arrows), extension into the left pedicle ( blue arrow) and anterior epidural extension ( orange arrow). Almost complete reduction in T1 signal of the vertebral body is also suggestive of infiltration but less convincing than the findings above.
Image Above: Loss of posterior cortex black signal ( pink arrows). Compare with normal posterior cortical margin ( blue arrow). |
| IS IT FOOL PROOF? |
| No, as not all pathological fractures will have these findings but if they are present it makes it strongly suggestive.
|
| WHAT TO DO IF IT’S NOT CLEAR? |
|
At times it will not be possible to make a definite decision as the findings are indeterminate if its benign or malignant. What to do then
If all of those end up negative then the two options remaining are for a biopsy or wait and rescan to see if it evolves like a benign or pathological fracture. |
