72-year-old alcoholic patient with intractable dorsal pain and legs numbness and weakness.
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IMAGING FINDINGS:
Thoracic spine compression fracture with posterior displacement of the posterior wall of the vertebral body compromising the spinal canal, cord compression and associated myelopathy. T2W image shows fluid and hypointense bubble-like artifact consistent with vacuum cleft in the collapsed anterior vertebral body
DIAGNOSIS:
Kümmel disease (osteonecrosis and collapse of the vertebral body)
TEACHING POINTS:
Intravertebral vacuum cleft and fluid within the collapsed vertebral body is a characteristic feature
Differential diagnosis includes a pathologic (tumoral) fracture, and the presence of air strongly favors osteonecrosis
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MR T2-weighted and CT images to highlight the characteristic features of Kümmel disease
Intravertebral fluid seen on T2 image and air on CT image
