title: [Differentiation between acute osteoporotic and metastatic vertebral body fractures by imaging].
abstract: OBJECTIVE
  This article discusses the morphological criteria for the differentiation between acute osteoporotic and metastatic vertebral body fractures and new imaging methods, such as diffusion-weighted and chemical shift magnetic resonance imaging (MRI) are presented.
  
  
  BACKGROUND
  The differential diagnostics of osteoporotic and metastatic vertebral body fractures can be difficult in some cases. Both entities normally occur without adequate trauma and predominantly in elderly patients.
  
  
  METHODS
  Conventional X-ray examination is the initial imaging method of choice but is not able to reliably differentiate between the osteoporotic or metastatic etiology of a fracture. Computed tomography (CT) clearly depicts osseous destruction in metastatic fractures but lacks specificity. Magnetic resonance imaging (MRI) shows a higher sensitivity and specificity in differentiating osteoporotic and metastatic fractures.
  
  
  METHODS
  The combination CT and MRI allows an accurate diagnosis with respect to an osteoprorotic or metastatic etiology in most of cases but bone marrow edema in acute fractures sometimes leads to ambiguous results and differential diagnostic problems.
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland, tobias.geith@med.uni-muenchen.de.
authors.forename: T
authors.initials: T
authors.lastname: Geith
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: A
authors.initials: A
authors.lastname: Baur-Melnyk
mesh_terms: D000208:Acute Disease; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology; D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058866:Osteoporotic Fractures / Q000175:diagnosis*; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*