Codfish vertebra sign

Description

A woman aged 70 years presented with several years' history of low back pain and bilateral lower limb pains. Her menstrual cycles ceased when she was 44 years of age. Plain X-ray of the lumbosacral spine revealed diffuse osteoporotic changes (figure 1). A battery of investigations was performed; the only abnormal results were slightly raised serum alkaline phosphatase (probably from vertebral fractures) and very low-serum 25-hydroxyvitmain D. Lumbosacral spine MRI was ordered (figure 2) and revealed several codfish vertebrae in addition to lumber spinal stenosis. Dual X-ray absorptiometry revealed a T-score of –2.9 at the spine. The patient's diagnosis was postmenopausal osteoporosis.

Figure 1

Lateral X-ray film of the lumbar spine, which reveals biconcavity of the lumbar vertebrae and osteopenia.

Figure 2

Sagittal T1-weighted (right) and T2-weighted (left) MRI of the lumbosacral spine. The D10–12 vertebrae are also...

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