title: The vacuum cleft sign: an uncommon radiological sign.
abstract: The intravertebral vacuum cleft sign (VCS) is an uncommon radiological sign, characterized by a radiolucent zone in the vertebral body. It is composed of 95% nitrogen and small amounts of oxygen and carbon dioxide. Post-traumatic ischemic necrosis could be its physiopathological mechanism, along with other pathologies like osteoporosis, corticosteroid therapy, diabetes, arteriosclerosis, alcoholism, multiple myeloma, bone metastasis and osteomyelitis. The broad diagnosis is made by antero-posterior X-ray, but computed tomography scan (CT scan) and magnetic resonance imaging (MRI) may help with the differential diagnosis. The aims of this paper are, on one hand, to communicate the clinical case of a 73-year-old osteoporotic woman with traumatic vertebral fractures who developed this sign in her radiological survey. On the other hand, its secondary aims are to review the medical literature about this sign and to show the clinical and radiological evolution after a percutaneous vertebroplasty.
authors.affiliation: Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836, 1o piso (1012), Buenos Aires, Argentina. msarli@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Sarli
authors.forename: F C
authors.initials: FC
authors.lastname: Pérez Manghi
authors.forename: R
authors.initials: R
authors.lastname: Gallo
authors.forename: J R
authors.initials: JR
authors.lastname: Zanchetta
mesh_terms: D000368:Aged; D015519:Bone Density; D003937:Diagnosis, Differential; D005260:Female; D005740:Gases / Q000032:analysis*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D005740:Gases
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