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Age / Sex : 50 / M
Chief complaint : lower back pain, 1 month ago
What is your diagnosis?
Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)
Courtesy : 최윤선 (Yun Sun Choi), 노원을지대학교병원 (Nowon Eulji Medical Center, Eulji University)
Diagnosis: Polyostotic fibrous dysplasia
Discussion
Findings
1. T-L spine radiographs and T spine CT
Expansile osteolytic lesions with ground glass opacity and a sclerotic rim are noted in the T6, T8, T9, T10, T12, L1, L2, and both ribs (right greater than left). Reformatted sagittal CT scan shows contour deformities and compression fractures in the T6, T8, and T9 vertebrae.
2. T spine MRI
Multiple bony lesions show heterogeneous low signal on T1WI and intermediate to high signal on FST2WI. Some cystic components show an inner fluid-fluid level, particularly in the posterior elements of T8 and T9. After contrast injection, these lesions show heterogeneous enhancement. These lesions compress the spinal cord at the T7-8-9-10 levels.
References
Kushchayeva YS, Kushchayev SV, Glushko TY, Tella SH, Teytelboym OM, Collins MT, et al. Fibrous dysplasia for radiologists: beyond ground glass bone matrix. Insights Imaging. 2018;9(6):1035-1056
Park SK, Lee IS, Choi JY, Cho KH, Suh KJ, Lee JW, et al. CT and MRI of fibrous dysplasia of the spine. Br J Radiol. 2012;85(1015):996-1001
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