Vertebral Compression Fractures

Case A: Approximately one-third loss of height of the L2 vertebral body is present from compression deformity of the inferior L2 endplate. Hypointense signal abnormality partially replaces the normal marrow signal in the lower half of the vertebral body on T1-weighted images, with corresponding hyperintense signal abnormality on STIR images. A hypointense fracture line can be seen parallel to the inferior endplate on T1 and T2 images, and there is mild retropulsion of a small fracture fragment from the posteroinferior corner of the vertebral body.

Case B: Compression deformities of both the superior and inferior endplates of the L1 vertebral body are present, with convex bowing of the posterior vertebral body margin into the spinal canal. Low signal completely replaces the normal T1 bright marrow signal on T1-weighted imaging. STIR images demonstrate diffusely hyperintense signal abnormality within the vertebral body as well as the pedicle. On contrast-enhanced imaging, diffuse heterogeneous enhancement of the vertebral body is present with confluent paraspinal and epidural soft tissue extension. Additional enhancing lesions can be seen in the S1 vertebral body and the L5 spinous process.