Imaging Case of the Week 165 Answer

The thoracic spine x-ray shows destruction of the left pedicle of the T8 vertebra by a lytic process (winking owl sign). In the context of acute renal failure and hypercalcaemia, this is likely to be a myeloma deposit. Myeloma was confirmed on further tests.

lytic area T8 left pedicle

winking owl sign 1