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Research ArticleOther & Special Categories

Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy

PAOLO SPINNATO, ALBERTO BAZZOCCHI, GIANCARLO FACCHINI, GIACOMO FILONZI, CRISTINA NANNI, ILARIA RAMBALDI, EUGENIO RIMONDI, STEFANO FANTI and UGO ALBISINNI
International Journal of Spine Surgery December 2018, 12 (6) 673-679; DOI: https://doi.org/10.14444/5084
PAOLO SPINNATO
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD
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ALBERTO BAZZOCCHI
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD, PHD
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GIANCARLO FACCHINI
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD
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GIACOMO FILONZI
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD
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CRISTINA NANNI
2Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
MD
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ILARIA RAMBALDI
2Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
MD
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EUGENIO RIMONDI
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD
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STEFANO FANTI
2Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
MD
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UGO ALBISINNI
1Diagnostic and Interventional Radiology, IRCCS Instituto Ortopedico Rizzoli, Bologna, Italy
MD
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    Figure 1

    Distribution of patients' age.

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    Figure 2

    Anathomopathological results.

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    Figure 3

    Magnetic resonance imaging study (sagittal fat suppression T2 weighted on the left) showed multiple vertebral fractures in an 8-year-old patient; PET-CT was negative (on the right). Biopsy has been performed on 2 different vertebral bodies without any diagnosis (normal bone structure).

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    Figure 4

    Computed tomography-guided vertebral biopsy level (not considering procedure's repetitions).

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    Figure 5

    Magnetic resonance imaging studies (sagittal fat suppression T2 weighted) showed fracture of T6 in a 6-year-old patient (on the left) and fracture of T9 and T11 in an 8-year-old patient (on the right) with similar radiologic patterns but different anatomopathological results: osteomyelitis (on the left) and eosinophilic granuloma (on the right).

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    Figure 6

    Anatomopathological diagnosis in patients 44 years old or older (range 44–78 years).

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    Figure 7

    Anatomopathological diagnosis in patients 10 years old or younger (range 6–10 years).

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    Figure 8

    Magnetic resonance imaging showed recent L1 fracture with strong bone edema (short tau inversion recovery sagittal sequence; on the right) and fluid in paravertebral space (arrows), without focal lesions detectable. Computed tomography confirmed the fracture (upper left). Computed tomography-guided vertebral biopsy, performed on L1 (down left), revealed multiple myeloma.

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International Journal of Spine Surgery
Vol. 12, Issue 6
1 Dec 2018
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Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy
PAOLO SPINNATO, ALBERTO BAZZOCCHI, GIANCARLO FACCHINI, GIACOMO FILONZI, CRISTINA NANNI, ILARIA RAMBALDI, EUGENIO RIMONDI, STEFANO FANTI, UGO ALBISINNI
International Journal of Spine Surgery Dec 2018, 12 (6) 673-679; DOI: 10.14444/5084

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Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy
PAOLO SPINNATO, ALBERTO BAZZOCCHI, GIANCARLO FACCHINI, GIACOMO FILONZI, CRISTINA NANNI, ILARIA RAMBALDI, EUGENIO RIMONDI, STEFANO FANTI, UGO ALBISINNI
International Journal of Spine Surgery Dec 2018, 12 (6) 673-679; DOI: 10.14444/5084
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