Case 10

History
40 year old female with back pain.

Diagnosis?

Diagnosis
Vertebra plana secondary to metastatic breast carcinoma.

Findings
Lateral lumbar radiograph shows markedly collapsed, markedly flattened and "wafer-like" L5 vertebral body.

Discussion
Vertebral plana has many causes including eosinophillic granuloma, Calve-Kummel-Verneuil disease (avascular necrosis of the vertebral body), Ewings, lymphoma, leukemia, metastases, myeloma, Gaucher disease, aneurysmal bone cyst, giant cell tumor and infection.

Pneumonics for vertebra plana:

“FETISH”
Fracture
EG
Tumor
Infection
Steroids
Hemangioma

“MELT”
Metastases, Multiple myeloma
EG
Lymphoma
Trauma, TB

Reference
1. Canale: Campbell's Operative Orthopaedics, 10th ed. Mosby, Inc. Page 824-825.

Submitted by Paul Clifford, MD
Reviewed by Robert Martinez, MD