Differentiation of Benign and Malignant Vertebral Compression Fractures

  • Andrea Baur-Melnyk
  • Tobias Geith
Part of the Medical Radiology book series (MEDRAD)


The differentiation between acute benign osteoporotic and malignant vertebral fractures is sometimes challenging, since they both occur without adequate trauma and are common in the elderly population. Conventional X-ray is the first imaging method to depict vertebral fractures, however it lacks specificity. CT allows better delineation of osseous destruction in neoplastic fractures, however it is not always possible to define the exact cause of the fracture. MRI is more specific as well as more sensitive in detecting especially discrete osteoporotic fractures. In most cases the combination of morphological signs in CT and MRI allows the determination of a benign or malignant cause of the vertebral fracture. However, there remain uncertain cases with contradictory imaging features. In the following chapter, we discuss the morphological signs which help in the differentiation between acute benign and neoplastic vertebral fractures. We describe the latest techniques such as diffusion-weighted, chemical-shift, and perfusion MRI as well as nuclear-medical techniques.


Apparent Diffusion Coefficient Vertebral Fracture Vertebral Body Osteoporotic Fracture Standardize Uptake Value 
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© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Institut für Klinische RadiologieKlinikum der Universität Munchen-GroßhadernMunichGermany

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