Imaging Case of the Week 192 Answer

The lateral view of the lumbar spine x-ray shows a wedge compression fracture of the L1 vertebra. The interesting feature here is the presence of a lucency in the vertebral body. Could it be a pathological fracture?

L1 wedge compression fracture

A CT scan of the affected area indicated that the lucency is due to the vacuum phenomenon, i.e. the collection of intra-discal air in the vertebral body.

Lumbar CT sagittal

One can also note a calcified aorta on the plain x-ray as well as the CT film.