Study design: A case of idiopathic focal vertebral body osteonecrosis without vertebral collapse is reported.
Objectives: To report a rare case of focal vertebral osteonecrosis and to clarify the features of imaging studies.
Summary of background data: There are no previous reports describing focal vertebral body necrosis without collapse in the literature.
Methods: A case report and literature review are presented.
Results: Imaging studies demonstrated: 1) sclerotic change on computed tomography scan; 2) low intensity on T1, high intensity on T2 with clear margin, and no gadolinium enhancement on magnetic resonance imaging; and 3) no uptake on bone scan. Histologic examination revealed empty lacunas, fatty necrosis with vacuolar degeneration, and cell debris compatible with bone marrow necrosis.
Conclusion: Vertebral body osteonecrosis must be considered a possible diagnosis of patients presenting with low intensity on T1, high intensity on T2 with clear margin, and no gadolinium enhancement on magnetic resonance imaging.