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Case of the Week 587


What is the most likely diagnosis?

  • 67 year-old complaining of low back pain



Close-up of Lower Lumbar Spine
Lateral Radiograph

  1. Paget Disease
  2. Renal Osteodystrophy
  3. Hemangioma
  4. Metastases
  5. Multiple Myeloma

Additional image - Axial CT of Spine

 

 

Additional Images

 


Axial CT of Spine


Answer:

 

3. Hemangioma

 

More (Click Discussion Tab)

 

 

Hemangioma

 

General Considerations

  • Benign
  • Most often located in lower thoracic, upper lumbar spine
    • Skull is second most common location (spoke-wheel appearance)
  • Mostly asymptomatic
  • More frequent in females
  • Peak incidence in 40’s
  • Multiple in up to 1/3 of cases
  • Most often occur in the medullary cavity of bone
  • Microscopically, there is hamartomatous proliferation of vascular tissue
    • Classified as to cavernous, capillary, arteriovenous and venous
    • Spine hemangiomas are usually capillary type; skull are cavernous


MORE . . .

 


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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.