Radiological Diagnosis of Chronic Back Pain

Abstract

A 65-year-old female presented with chronic back pain after undergoing two months’ treatment elsewhere with little improvement. She had a history of a trivial injury some eight months earlier when she received treatment and became ambulatory. For the previous three months, she was having difficulty being supine. Her pain and discomfort were obvious. X-ray radiographs in supine and sitting postures suggested a collapse opening up at D12 level suggestive of a void. Computed tomography (CT) confirmed a ‘vacuum sign’ seen on coronal and axial cuts. Magnetic resonance imaging (MRI) clearly showed an edema at that particular level. Laboratory test results ruled out any infection or malignancy. The patient underwent a single-level kyphoplasty (KP) under anesthesia. On the following day, her pain score (visual analog score) had tremendously improved from 8 to 1. The chest x-ray and CT scan showed satisfactory cement filling and height restoration. She received anti-osteoporotic treatment and was doing well at the one year follow-up.

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