This document discusses loss of height or collapse of one or more vertebral bodies, which can be caused by several conditions. It provides 10 figures showing examples of vertebral body collapse or loss of height due to severe osteoporosis, multiple myeloma, tuberculous osteomyelitis, brucellosis, fracture, Scheuermann's disease, Langerhans cell histiocytosis, Morquio syndrome, spondyloepiphyseal dysplasia, sickle cell anemia, and osteogenesis imperfecta. Each figure illustrates the characteristic radiographic findings of vertebral body abnormalities associated with each condition.

1. 6Loss of Height of One or More
Vertebral Bodies

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

3. • Fig SP 6-1 Severe osteoporosis. (A) Lateral and (B)
frontal views of the thoracolumbar spine show striking
demineralization and compression of multiple
vertebral bodies in a 14½-year-old girl treated with
steroids for 5 years for chronic glomerulonephritis. The
height age of the girl was only 9 years at this time.6

4. • Fig SP 6-2 Multiple myeloma. The diffuse
myelomatous infiltration causes generalized
demineralization of the vertebral bodies and a
compression fracture of L2.

5. • Fig SP 6-3 Tuberculous osteomyelitis of the
thoracic spine. (A) Initial film demonstrates
vertebral collapse and anterior wedging of
adjacent midthoracic vertebrae (arrow). The
residual intervertebral disk space can barely be
seen. (B) Several months later, there is virtual
fusion of the collapsed vertebral bodies,
producing a characteristic sharp kyphotic
angulation (gibbous deformity).

6. • Fig SP 6-4 Brucellosis. (A) Frontal plain film of the lower
thoracic spine demonstrates loss of height of the T11
and T12 vertebral bodies with destruction of the end
plates and swelling of the paravertebral soft tissues
(arrows). (B) A lateral tomogram of the lower thoracic
spine demonstrates cortical destruction with sclerosis
of the inferior end plate of T11 and the superior end
plate of T12 (arrows). There is a mild degree of anterior
wedging. The overall radiographic appearance is
indistinguishable from that of tuberculous spondylitis.

7. Fig SP 6-5 Fracture. Characteristic anterior wedging of the
superior end plate of the L1 vertebral body.

8. • Fig SP 6-6 Scheuermann's disease. Irregularity
of the vertebral end plates and wedging of the
vertebral bodies, which causes an arcuate
kyphosis.7

9. • Fig SP 6-7 Langerhans cell histiocytosis. (A)
Frontal and (B) lateral views of the spine show
complete collapse with flattening of the T12
vertebral body (vertebra plana).

10. • Fig SP 6-8 Morquio syndrome. Generalized
flattening of the vertebral bodies in the (A)
cervical and (B) lumbar regions.

11. • Fig SP 6-9 Spondyloepiphyseal dysplasia.
Generalized flattening of the vertebral bodies
(platyspondyly).

12. • Fig SP 6-10 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.

13. • Fig SP 6-11 Osteogenesis imperfecta.
Generalized flattening of vertebral bodies
associated with fractures of multiple ribs and
long bones in an infant.