Limbus Vertebra

General Considerations

• Common finding
• Most commonly affects the anterosuperior corner of vertebral body in a single vertebral body
  • May also affect the inferior margin less commonly and posterior margins least commonly
• Seen mostly in mid-lumbar spine
• Probably due to trauma
• Caused by herniation of a portion of the nucleus pulposus underneath the ring apophysis before its fusion to the body
• Ring apophysis stays separate from the main body

Clinical Findings

• Posterior limbus vertebra have been reported to cause nerve compression
• Anterior limbus vertebra are not believed to cause symptoms

Imaging Findings

• Triangular fragment of bone at anterosuperior corner of a vertebral body
• Sclerotic margins to fragment
• Sclerotic margin of adjacent vertebral body

Differential Diagnosis

• Fracture
  • Typically do not have sclerotic margins like limbus vertebra
• Discitis
  • Especially in children where a limbus vertebra may not have a sclerotic margin
• Schmorl's node
  • More central defect also caused by herniation of nucleus pulposus

Treatment

• None needed

Complications

• None

Limbus vertebra	Limbus vertebra
Discitis	Fracture

Limbus vertebra (and look-alikes). The limbus vertebra (top) shows corner fragments that are well-corticated (white arrows) The same bodies contain Schmorl's nodes (yellow arrows). Discitis (lower left) destroys two adjacent endplates (yellow and white arrows) and the intervening disk space. The edges are not sclerotic. The fracture has non-sclerotic margins (white arrow) and extends through the vertebral body (blue arrow).
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The Limbus Vertebra: An Anterior Disc Herniation Demonstrated by Discography. Bernard Ghelman And Robert H. Freiberger. Am J Roentgenol 127:854-855, 1976