1. 1Generalized Vertebral
Osteoporosis

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig SP 1-1 Osteoporosis of aging. Generalized
demineralization of the spine in a
postmenopausal woman. The cortex appears
as a thin line that is relatively dense and
prominent (picture-frame pattern).

4. • Fig SP 1-2 Steroid-induced osteoporosis. Lateral
view of the thoracic spine in a patient on high-
dose steroid therapy for dermatomyositis
demonstrates severe osteoporosis with thinning
of cortical margins and biconcave deformities of
vertebral bodies.

5. • Fig SP 1-3 Cushing's syndrome due to adrenal
hyperplasia. Marked demineralization and an almost
complete loss of trabeculae in the lumbar spine. The
vertebral end plates are mildly concave and the
intervertebral disk spaces are slightly widened. Note
the compression of the superior end plate of L4.1

6. • Fig SP 1-4 Multiple myeloma. Diffuse
myelomatous infiltration causes generalized
demineralization of the vertebral bodies and a
compression fracture of L2.

7. • Fig SP 1-5 Sickle cell anemia. (A) Biconcave
indentations on both the superior and inferior
margins of the soft vertebral bodies produce the
characteristic fish vertebrae. (B) Localized step-
like central depressions of multiple vertebral end
plates.

8. • Fig SP 1-6 Osteogenesis imperfecta. In addition to
generalized osteoporosis, some vertebrae show
biconcave deformities, whereas others
demonstrate anterior wedging.2

9. • Fig SP 1-7 Homocystinuria. Scoliosis and
osteoporosis.2

10. • Fig SP 1-8 Idiopathic juvenile osteoporosis. Lateral
radiographs of (A) thoracic and (B) lumbar regions of the
spine show striking osteoporotic lucency associated with
severe compression and collapse of multiple vertebral
bodies. Note the ballooning of several disk spaces.2